What is a characteristic of Exclusive Provider Organizations (EPO)?

The characteristic of Exclusive Provider Organizations (EPO) that is identified as correct emphasizes that services are only covered if patients utilize in-network doctors or hospitals. This is a fundamental aspect of EPO plans; they are designed to keep costs down by requiring members to seek care exclusively from a specific network of providers. If a member seeks treatment outside this network, they will generally not have coverage for those services, except in emergencies.

EPOs aim to control healthcare costs while still providing a range of health services to its members. They usually do not require referrals for specialists, which allows for greater flexibility in accessing healthcare. This flexibility can be appealing to patients who want more autonomy over their healthcare decisions compared to options that require referrals for every service. However, the critical distinction of EPOs lies in their network restriction, which significantly manages the costs for the insurance provider and encourages patients to stay within the network for non-emergency services.