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 cost of the plan is higher than an HMO. Also, your out-of–pocket costs will be higher. The right PPO plan for you will depend on your budget and your needs. There are many benefits to choosing a PPO.
One of the biggest advantages of a PPO plan is flexibility. Providers can be found in nearly every state and city. This allows you to easily locate the best doctors and medical care in your locality. In-network care is rewarded by the PPO network, so you may pay less to get the services you need.
Another benefit of a PPO is the ability to choose your own primary care physician. Some cases will not require you to get a referral form your PCP in order for you 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.
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. However, you will still need to pay for care that you receive outside the network. 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 gives you greater options for testing and laboratory locations. You can access the care you require, whether you're at home or on the road.
When choosing a PPO, you must also consider copays, deductibles, and coinsurance. Deductibles are a fixed amount you have to pay each year before your health insurance coverage kicks in. The first $1,000 of your costs is usually covered. Your insurance company will usually cover the remainder. You pay a fixed amount of money each time you visit a provider. Depending on which plan you have, you might also need to pay for birth control and tonsillectomies. The pharmacy can be paid for by you, but your insurance company will determine what prescriptions are covered.
PPO health insurance policies are an excellent choice for those who self-manage their medical care. It is a great option for people who travel frequently and want the ability to see any health care provider. It all comes down to your individual needs and budget.