A Preferred Provider Organization (PPO) plan is similar to a Health Maintenance Organization (HMO) plan, but it does not require a primary care provider to manage your health services. You have more autonomy over your care.
If you want the freedom to see your preferred provider, a Preferred Provider Organization might be a better option. A PPO might also be a better decision if you need medical attention frequently and from certain specialists.
A Preferred Provider Organization (PPO) plan is similar to a Health Maintenance Organization (HMO) plan, but it does not require a primary care provider to manage your health services. You have more autonomy over your care. If you want the freedom to see your preferred provider, a Preferred Provider Organization might be a better option. A PPO might also be a better decision if you need medical attention frequently and from certain specialists.
Like HMOs, PPO plans take advantage of having a network of providers to reduce medical costs. PPOs have networks of health care providers, and these networks are bigger than those for HMO plans.
Unlike HMOs, a PPO plan will cover some of your out-of-network costs. If you go to an out-of-network provider, your costs will be higher but your plan will cover at least some of the fees. Staying in your network will result in the lowest out-of-pocket fees.
Premiums and out-of-pocket costs are higher with PPOs than other health insurance plans. These higher expenses are the cost of freedom and flexibility to choose your preferred provider.
Most PPOs also have a deductible you will need to meet before the plan covers services. You plan might have fixed copayments or coinsurance percentages you pay for certain services like:
- Emergency room visits.
- Wellness visits.
- Hospitalization.
- Prescription drugs.
- Laboratory services.
Looking for a plan that is in the middle of the road? You may want a plan that is part HMO and part PPO.
By Admin –
