What is a Preferred Provider Organization (PPO) plan?
Although it is not required that you do so, when you use the insurance company’s network of preferred doctors and hospitals, a PPO plan will have lower costs. If you choose an out-of-network provider, the cost will be much higher. In-network healthcare providers have predetermined rates, usually nominal, for the provision of each service to the health insurance plan’s members. Consider the following example: Let’s assume that the out-of-network coverage rate is sixty percent. This means that the insurance company will pay sixty percent of what that service would have cost had you gone to an in-network provider. If you received $500 worth of services from an out-of-network provider and those same services were available from an in-network provider for $250, the insurance company will only pay sixty percent of $250, which is $150, leaving you responsible for the remaining $350. Another consideration is that not only may up-front payment be required, but the out-of-network provider will n
Related Questions
- All I have on my enrollment for medical choices are the EBPA Plan, Preferred Provider Organization (PPO) and a waive option. Why?
- Can you explain the Harvard Pilgrim’s Preferred Provider Organization (PPO) plan that’s displayed on my worksheet?
- What is a Preferred Provider Organization (PPO) plan and how does it work?
