A PPO plan, a type insurance policy that covers your health, allows you to go to any doctor or hospital within the network or outside of it. However, the plan can cost more than an HMO, and your out-of-pocket costs are higher. A PPO may be right for you depending on your needs and your budget. A PPO has many benefits.
Flexibility is one advantage of a PPO. There are many providers in PPO networks, which can be extremely large. This means that you can easily find the best doctors or medical care in your area. Because the PPO network rewards in-network care you may be able to pay less out of pocket for the services you need.
A PPO offers another benefit: the freedom to choose your preferred primary care doctor. In some cases, you will not need a referral from your PCP to see a specialist. It is possible to visit specialists without the referral of your PCP. You may also need to pay a copay (or a fixed amount) for certain healthcare services.
This cost could be avoided by calling your insurance company before receiving care from an outside-of-network provider. You can avoid having your claim denied by calling the insurance company.
If you have a private medical plan (PPO), you can access any provider in your network. You have the option to choose the doctor that you like. However, you are still obligated to pay for any care you receive outside of the network. Although insurance companies and physicians often agree to lower the usual rates for their services, you could still end up paying more if they choose to refer you to an out of network provider.
A PPO has another advantage: your doctor and other medical professionals are able to negotiate rates and schedules with health facilities. You'll have more options when it comes to testing and lab locations if you have a PO. The result is that you can get the care and treatment you need regardless of where you are.
Other factors that you should consider when selecting a PPO include deductibles and copays. Deductibles are a fixed amount you have to pay each year before your health insurance coverage kicks in. Typically, the first $1,000 of your costs are covered. The rest will be covered by your insurance company. Copays are fixed dollar amounts you pay each time you have a visit to a provider. Depending on your plan, you may also have to pay for birth control or tonsillectomies. The pharmacy can be paid for by you, but your insurance company will determine what prescriptions are covered.
PPO insurance policies are a good option for people who manage their own healthcare. It is a great option for people who travel frequently and want the ability to see any health care provider. You will need to consider your specific needs, your budget, as well as your lifestyle.