A PPO (Preferred Provider Organization) is a very popular managed care health insurance product. The benefits this product offers is structured around a network of medical professionals. The benefits are structured around specific medical coverage.
These plans let you choose the medical professionals of your choice. They have a contracted network of professionals that offer negotiated rates for added savings. But even if you go out of the network you still get a reduced benefit to help with the expense.
This product has what is called an annual deductible amount. What this is, is a dollar amount that you are responsible for meeting before the insurance company will share the expense. So if you incur medical expenses during the year they will be deducted from the deductible. For example you may have to meet $2000 annually.
Once you have met that deductible you may then have co insurance. Co insurance is a set amount that you must pay out of pocket, but usually at a reduced rate. For example, you may have to pay 20% of the expenses until you have met the co insurance amount.
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%.
Most PPO plans have a benefit called a co-pay. A co-pay is a specific amount you would have to pay for certain medical treatments, such as office visits and prescriptions. A co-pay helps offset some of your basic expenses.
Consumers love that with a PPO they can see and medical professional they choose. Even a specialist, without the need of a referral. They can go to a medical professional or facility that is not in network and still get some benefit.
Choosing to go with a PPO has its advantages and disadvantages. Get to know all the facts. Compare what your medical needs and budget might be to the options that are available in a PPO plan.
These plans let you choose the medical professionals of your choice. They have a contracted network of professionals that offer negotiated rates for added savings. But even if you go out of the network you still get a reduced benefit to help with the expense.
This product has what is called an annual deductible amount. What this is, is a dollar amount that you are responsible for meeting before the insurance company will share the expense. So if you incur medical expenses during the year they will be deducted from the deductible. For example you may have to meet $2000 annually.
Once you have met that deductible you may then have co insurance. Co insurance is a set amount that you must pay out of pocket, but usually at a reduced rate. For example, you may have to pay 20% of the expenses until you have met the co insurance amount.
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%.
Most PPO plans have a benefit called a co-pay. A co-pay is a specific amount you would have to pay for certain medical treatments, such as office visits and prescriptions. A co-pay helps offset some of your basic expenses.
Consumers love that with a PPO they can see and medical professional they choose. Even a specialist, without the need of a referral. They can go to a medical professional or facility that is not in network and still get some benefit.
Choosing to go with a PPO has its advantages and disadvantages. Get to know all the facts. Compare what your medical needs and budget might be to the options that are available in a PPO plan.
About the Author:
If you are needinga PPO plan broker Jeff Cline can assist. If you are needingNevada Health Insurance or any other State he can assist. 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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