Which statement is true regarding Exclusive Provider Organizations (EPO)?

The statement regarding Exclusive Provider Organizations (EPO) that is true is that EPOs pay nothing for services obtained outside the provider network. This characteristic is a core feature of EPO plans; they require members to utilize a specified network of healthcare providers for coverage, and services rendered outside this network typically do not receive any reimbursement.

This structure incentivizes enrollees to seek care from in-network providers, ensuring that the insurance company can manage costs effectively. Consequently, patients must be aware that unless they have an emergency or other exceptions outlined in their plan, seeking care outside of the network can result in significant personal expense, as these services are not covered financially by the EPO plan.

This highlights the importance of understanding the network requirements of EPOs for managing healthcare expenses.