by Jeff Cline
A Preferred Provider Organization (PPO) is a managed care product. It is health insurance available to consumers that have structured benefits and a professional network of medical professional.
Even though a PPO encourages its members to stay in network by promising a negotiated rate or contracted rate you have the freedom to see any professional you would like and still get some benefit.
These plans have a set deductible amount. Typical it is an annual dollar amount. A deductible may be $2000. Throughout the year as you incur medical expenses they will go towards your deductible amount. If you met that the insurance company will start to share expenses with you.
After your deductible is met the insurance company may pay 100% of expenses incurred. But, more often they split the expense up to a certain amount. For example, your benefit may be 80/20 with a co insurance max. Of $2000. So you would be required to pay 20% up to $2000.
So when you here the phrase “out of pocket maximum”, what they are talking about is your deductible + co insurance. So if you have a deductible of $3000 + a Co insurance amount of $2000. You would be expected to pay $5000 out of your pocket before the insurance company would pay 100%.
Another way a PPO helps offset some of your out of pocket expense is by offering a co-payment. A co-payment is specific dollar amount you will pay for specified medical treatments. The most common co-payments are seen with an office visit or prescription medication.
Consumers really like the freedom of choice that a PPO provides to them. They can see any medical professional and still get some sort of benefit. With a HMO you must only see providers that are in the network.
You will need to become familiar with all of the facts in regards to a PPO product. Compare all the facts with your needs and budget before deciding if it is for you. This article has covered some of the basics, but there is more to know.
About the Author:
Are you looking for a PPO plan agent Jeff Cline can help. Are you looking for Nevada Health Insurance or any other State he can help. For affordable Temporary Health Insurance he has answers also. give him a call 24 hours a day, 7 days a week at his toll free number 866-526-9669.
A Preferred Provider Organization (PPO) is a managed care product. It is health insurance available to consumers that have structured benefits and a professional network of medical professional.
Even though a PPO encourages its members to stay in network by promising a negotiated rate or contracted rate you have the freedom to see any professional you would like and still get some benefit.
These plans have a set deductible amount. Typical it is an annual dollar amount. A deductible may be $2000. Throughout the year as you incur medical expenses they will go towards your deductible amount. If you met that the insurance company will start to share expenses with you.
After your deductible is met the insurance company may pay 100% of expenses incurred. But, more often they split the expense up to a certain amount. For example, your benefit may be 80/20 with a co insurance max. Of $2000. So you would be required to pay 20% up to $2000.
So when you here the phrase “out of pocket maximum”, what they are talking about is your deductible + co insurance. So if you have a deductible of $3000 + a Co insurance amount of $2000. You would be expected to pay $5000 out of your pocket before the insurance company would pay 100%.
Another way a PPO helps offset some of your out of pocket expense is by offering a co-payment. A co-payment is specific dollar amount you will pay for specified medical treatments. The most common co-payments are seen with an office visit or prescription medication.
Consumers really like the freedom of choice that a PPO provides to them. They can see any medical professional and still get some sort of benefit. With a HMO you must only see providers that are in the network.
You will need to become familiar with all of the facts in regards to a PPO product. Compare all the facts with your needs and budget before deciding if it is for you. This article has covered some of the basics, but there is more to know.
About the Author:
Are you looking for a PPO plan agent Jeff Cline can help. Are you looking for Nevada Health Insurance or any other State he can help. For affordable Temporary Health Insurance he has answers also. give him a call 24 hours a day, 7 days a week at his toll free number 866-526-9669.
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