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 PPO plan may be more costly than an HMO. Additionally, your out-of pocket costs can be higher. Your needs and budget will determine if a PPO is right. A PPO offers many advantages.
Flexibility is one of the greatest benefits of a PPO plan. PPO networks can be very large, and providers can be found in almost any city or state. This allows you to find the best medical care and doctors in your region. 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. Some cases will not require you to get a referral form your PCP in order for you to see a specialist. If you do need a referral, however, you should know that you'll have to pay a higher rate if you visit a specialist without a PCP referral. For certain healthcare services, you might have to pay a copay or a fixed dollar amount.
Calling your insurance company before you seek out care from outside-of network providers may help to reduce this cost. It will protect your claim and prevent you from having to pay unnecessary treatments.
With a PPO you can choose any provider from the network. You will still be responsible for all care received outside 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 offers another benefit: Your doctor and any other medical professionals can negotiate with health facilities about fees and schedules. You'll have more options when it comes to testing and lab locations if you have a PO. You can receive the care you need even when you are away or traveling.
You should also take into account copays, deductibles and coinsurance when choosing a PO. Deductibles are the amount you have each year to pay before your insurance coverage kicks into effect. You are usually covered for the first $1,000. Your insurance company will usually cover the remainder. The copay is a fixed dollar amount you pay for each visit to a provider. Depending on your plan and other factors, you might have to pay for tonsillectomies (or birth control). You can also purchase prescription medications at the pharmacy. But you'll need to verify with your insurance company what type of prescriptions are covered.
For those who manage their own health care, a PPO policy can be a great option. It is a great option for people who travel frequently and want the ability to see any health care provider. Ultimately, the health insurance plan that's right for you depends on your needs, your budget, and your lifestyle.