My wife and I have to decide what sort of insurance we want. I am fairly unversed in these things. I need to know what you know about EPO (Exclusive Provider Organization) coverage. EPO does not offer most out-of-network benefits, though it does offer out-of-network emergency and urgent care benefits. This is not so much a problem for us, as we can easily pick a doctor from the list and go with that. Here are the benefits:
- no deductible
- $2500 maximum out of pocket
- $20 copay (up to $500) for preventive care
- $20 copay for well baby care
- prescription benefits
- $350 copay for hospital care, then 90% after that
- $20 copay for a physician office for illness or injury (includes lab and x-ray)
- $100 copay for outpatient surgery in the doctor's office
- $250 copay for outpatient surgery in a surgical facility
- $50 copay for emergency room visit (this would apply to out-of-network hospitals as well)
- $20 copay for urgent care (also applies to out-of-network)
- $50 copay (then 90% after that) for CT scans and MRIs
- It also includes chiropractic care, "durable medical equipment/special requirements" (whatever that is), mental health, and substance abuse benefits.
What do you guys and gals think?
Lon
- no deductible
- $2500 maximum out of pocket
- $20 copay (up to $500) for preventive care
- $20 copay for well baby care
- prescription benefits
- $350 copay for hospital care, then 90% after that
- $20 copay for a physician office for illness or injury (includes lab and x-ray)
- $100 copay for outpatient surgery in the doctor's office
- $250 copay for outpatient surgery in a surgical facility
- $50 copay for emergency room visit (this would apply to out-of-network hospitals as well)
- $20 copay for urgent care (also applies to out-of-network)
- $50 copay (then 90% after that) for CT scans and MRIs
- It also includes chiropractic care, "durable medical equipment/special requirements" (whatever that is), mental health, and substance abuse benefits.
What do you guys and gals think?
Lon
