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Exclusive Provider Organization (EPO) Overview

At CDPHP, we take care to make sure the providers you interact with are providing the best care they can. Imagine in-network care with no paperwork, no referrals, and no surprises.

The EPO plan includes:

  • Affordable copayments or coinsurance per visit after meeting your deductible (if any)
  • No claim forms or referrals
  • No charge for certain preventive care, including routine annual exams and screenings
  • Freedom to select your own providers of care within our national network
  • Worldwide coverage for emergency care

How it Works

With an EPO you are not required to select a primary care physician (PCP), although we encourage you to establish a relationship with a network PCP who will coordinate your care and refer you to network specialists as needed. You are responsible for paying a coinsurance or copayment when going for care. Please refer to the benefit materials provided to you at the time of enrollment for specifics on your out-of-pocket costs. These vary according to the plan purchased by your employer group.

FAQs

Q. Do I have access to out-of-network benefits?

A. Members of the EPO only have coverage for care provided within the CDPHP network. This includes access to a national network of 825,000+ providers of care.

 


This summary offers highlights but does not detail all benefits, limitations, or exclusions. It is not a contract and may be subject to change. For more detailed information, a Membership Certificate is available upon request.