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EPO

The EPO option is very similar to an HMO in the way benefits are applied. If you choose the EPO, you must receive treatment from an in-network provider. Only emergency services or urgent services received while out of the service area are covered when provided by out-of-network providers or facilities.


Factors to Consider:

  • Large selection of network providers in the Humana Choicecare PPO Network.
  • No referrals required for specialty care services.
  • No coverage for out-of-network services except for life- or limb-threatening emergency.
  • No deductibles to meet.
  • All payments are set co-pay amounts.

Prior authorization required for the following services:

  • Non-emergency In Patient Hospital Service
  • Out Patient Surgery
  • Mental Health and substance abuse services
  • Durable Medical equipment


For a detailed list, consult your Summary of Benefits.

last modified 2008-01-04 13:45
 

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