A PPO plan is a type of health insurance that allows you to see a doctor or hospital in network, or out of network. 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 can offer many benefits.
Flexibility is one the greatest advantages of a PPO. 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. You may also find that the PPO network makes it easier to pay for services in your area.
Another advantage of a PPO plan is the possibility to choose your own primary physician. Sometimes, you won't need to have a referral from your doctor in order to see a specialist. However, if you do require a referral from your PCP, you will be charged a higher fee if you go to a specialist without one. Not only that, but you may need to pay a fee for certain services.
It is possible to save money by calling your insurance before you get care from an out of network provider. Calling the insurance company before you receive care from an out-of-network provider can help to prevent your claim being denied. It also helps to avoid unnecessary costs.
When you have a PPO, you are free to use any provider in the network, so you have the flexibility to choose the physician you prefer. You are still responsible for paying for any outside-of-the-network care. While insurance companies and providers may agree to lower their rates for services, you still have to pay the full price if the provider is not in your network.
A PPO also offers the advantage that your doctor can negotiate fees and schedules with the health care facilities they work with. A PPO will give you more choices for testing and lab locations. You can receive the care you need even when you are away or traveling.
Other factors that you should consider when selecting a PPO include deductibles and copays. Your deductibles are the annual fixed amount you pay before your coverage begins. Typically, the first $1,000 of your costs are covered. Your insurance company will usually cover the remainder. A copay is an amount that you pay every time you visit a provider. Your plan may require you to pay for things like tonsillectomies and 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.
PPO policies can be an excellent option for self-managing your own medical care. It is ideal for people who frequently travel and want the freedom to visit any medical provider. The best health insurance plan for you is dependent on your personal needs, your budget and your lifestyle.