Anthem PPO vs EPO
Hi all, my employer is offering a new plan and was curious if folks had any thoughts or experience with an EPO…it seems like a very attractive plan as they say that the EPO plan gives you access to the same Anthem network as the PPO? My spouse & I have used our insurance quite a bit this past year (spouse had some medical scares) hoping that we don’t have a repeat however if we did the EPO, it would save us money in the long run? The EPO seems like it could be almost too good to be true, so I’m just wondering if I am missing anything. And all the specialists & doctors we saw this past year were within network. Any insights or things to consider would be very helpful, thanks in advance!
Anthem EPOAnthem PPO (In Network)Semi-Monthly Cost (myself + spouse)$110.32$107.15Deductible$0$250 person/$750 familyOut-of-Pocket Maximum$2000 person/$4000 family$2500 person/$5000 familyCoinsurance$010%Primary care visit to treat an injury or illness$15 copay$20 CopaySpecialist visit$15 copay$40 CopayOutpatient X-Ray or Outpatient Lab and Pathology0% coinsurance10% CoinsuranceOutpatient Surgery0% coinsurance10% CoinsuranceInpatient Hospital Care0% coinsurance10% CoinsuranceEmergency room servicesUrgeny Care – $15 copay. Emergency room services: $150 copay + 0% coinsuranceUrgent Care – $20 copay, Emergency room services: $150 copay + 10% coinsurancePreferred brand drugs$25 copay$30 copayNon-preferred brand drugs$45 copay$50 copaySpecialty drugs$40 copay$40 copay
