PPO, or Preferred provider organizations, is one of the four types of health insurance plans. It is composed of a network of physicians, hospitals, and other providers who offer reduced rates. As a PPO insurance holder, you have access to a number of providers in the network. With this health plan, a referral from a primary care doctor to visit an in-network provider is not necessary. You will also get to pay lower charges than when you require services outside the network.
Preferred Provider Organization Plans are ideal for individuals and families. As with other plan types, this plan was created to reduce rates. These reduced rates are offered due to the preferred provider network. Unlike HMOs, when you need to see a specialist, you may make an appointment with the specialist of your choice.
As with most insurance policies, PPO insurance has designated fees like a deductible. With regards to copay or coinsurance, you pay a flat copay fee of $15 at the time of your visit. In case the physician in your area charges more than others, you are obliged to pay the balance. Most often, PPOs are compared with the other types of health insurance, especially HMOs. Each insurance company offers several variables. However, it pays to shop and collect different offers from several insurers to help you decide. Here are some advantages about PPO insurance that may be helpful to you.
- Flexibility. Unlike other insurers, PPO policies give its members the freedom to visit any doctor or medical facility without prior referrals from a primary care physician.
- No referrals. If you are a PPO insurance holder, you can set appointments and receive treatment from specialists. Again, this does not require any referral from a primary care physician.
- Out-of-Network benefits. You are free to see a non-network doctor.
Unfortunately PPO plans do have a few drawbacks. The deductible is among the highest. The deductible can be as high as $2000. For some this may seem unappealing. However, once the deductible is paid the insurance company will pay for some if not all your care. This type of flexibility does come at an added cost. A PPO plan is perfect for those who already have a Primary Care Physician. In addition to having a co-pay, prescription drugs can be acquired for the low.
As with any health plan, you want to read all the benefits and coverage details. If you have questions regarding PPO insurance, let Blue Sky Coverage help you find a policy that suitable for you and your family. Call us today to get free insurance quotes.