PPO or EPO???

Does anyone know the difference between a PPO and a EPO, it is time to pick our insurance from my  husband's company and I'm not sure which would be better? Any help would be appreicated. LOL  Jen  

Hi Jen, Just my opinion, but if it is at all possible, try to get copies of both policies or benefit plans, anything that will describe the coverage for WLS.  Sometimes, this information is difficult to come by though, that's the problem.  Even if you could get a website to review.  However, if these are not options, it may be worthwhile to approach the HR person or Insurance Liason (or whatever the title may be).  I just suggest this as I did the following: found BC/BS of IL's policy on line, but wanted to be sure that my policy was the same...I called our company's insurance agency regarding any exclusions.  In your case, they should be able to clearly explain the benefits to you before you pick.

Sorry for the long response, but sometimes is better to know too much, instead of not enough. 

Good Luck!

I looked online, but it doesn't have the new policies yet, I'm assuming  there the same as the old ones just more money. But I will call HR and see if they can give me any info. I didn't think of that, Thank you LOL Jen

A PPO plan has deductibles and co-insurance, where as an epo plan only has copays like an hmo plan, but allows you the choice of going to who you want to go to, like the ppo plan. If the PPO and EPO are with the same insurance company, and they are a fully insured, insurance comany.. i.e. Blue Cross, Aetna, Cigna, blah blahb lahb and not with a self funded plan or third party administrator plan, then the rules on WLS should be the same for both.  As for choosing EPO vs. PPO, EPO is designed for sick people, just like the HMO plans were, which is why they cost you more in premiums. It will save your out of pocket a lot of money, but the premiums can be quite high. I suggest the EPO plan to people that have illnesses that need lifetime care for. The PPO plans are for people who don't get sick as often, and even the high dollar deductible plans are for people who never utilize healthcare at all. If someone wants to keep their premiums low, they opt for the high deductibles, and their company might offer a health savings plan, almost like a flex plan, to save money for the illnesses that you have. I don't think you get paid out if you don't use the money though, so I wouldn't ever go with a high dollar deductible, especially in your considering bariatric surgery.  Look at the bariatric surgery covered under both plans. Think about how cost effective it would be to have either of those plans. Think about the continued medical treatment you would need after bariatric surgery. That's the only way you're going to pick the right plan for you. Also, most importantly, read everything that plan document says, and if you don't understand it, ask questions. Its better to be safe than sorry with health insurance. And believe you me, they do try to stick it to you illegally too.

Thank you soooooo much for all the information, it can be so confusing when trying to decide what type of coverage is best. We went with the EPO, we might change next year for lower premiums but for this year we will probably have alot of health cost so we think the EPO might be worth it. Thank you, LOL Jen