Medical Expense✓ Verified · outline & fact-checked · Sep 2026Difficulty 2/5
An EPO (exclusive provider organization) plan differs from an HMO primarily in that an EPO:
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
An EPO combines features of HMOs and PPOs: like an HMO it limits coverage to the plan's network (no out-of-network benefits except emergencies), but like a PPO it generally does not require a primary care gatekeeper or referrals. The exam tests the EPO as the middle-ground plan type.
Why the other options are wrong
- B) EPOs do not generally require referrals, and they do not cover out-of-network care — both parts of this option are wrong.
- C) No EPO covers out-of-network care at 100% with no deductible; out-of-network care is generally excluded.
- D) EPO availability is a market/plan-design question, not a defining statutory feature of the EPO model itself.
Memory hook
EPO = Exclusive (network only) + no gatekeeper. HMO has the gate; PPO has the freedom; EPO has neither.