We would like to help you understand your PPO plan. So many people get confused so we are going to explain in detail the most confusing aspect of a PPO plan in details anybody can understand.
Preferred Provider Organization or PPO is very popular these days. Many people prefer this insurance over and HMO. The reason being, that a PPO gives you freedom to pick any doctor you want. If you stay in network however, you get an added discounted cost.
The deductible seems to be a very confusing part of a PPO plan. Your deductible may be something like $5000. If you have any hospitalization or procedures you would be expected to pay the first $5000, before the insurance company shares any cost.
Co insurance is what we are talking about when we say the insurance company will "share " some expenses with you. Your co insurance may be 70/30, up to $2000. So you will pay 30% up to an additional $2000 out of your pocket.
For example, you go to the hospital and your bill is $32000. We already know you have to pay $5000, so that leaves $27000 that you would have to pay 30% of up to the amount of $2000. The insurance company would pick up the rest.
So how does it look on paper? Total medical expense was $32000. Deduct your deductible that you are required to pay of $5000, that leaves $27000. Now your expected to pay 30% of the remains balance since your maximum is $2000, and 30% is $8100, you only pay $2000.
Now if you go to the hospital again in that same year you will pay nothing. Your deductible has been satisfied and your co insurance has been meet for the year. Your total out of pocket of $7000 has been paid.
Hopefully by now you understand the most misunderstood aspect of health insurance PPO's. You will never get another mystery bill in the mail from the hospital and have to call the insurance company asking why.
Preferred Provider Organization or PPO is very popular these days. Many people prefer this insurance over and HMO. The reason being, that a PPO gives you freedom to pick any doctor you want. If you stay in network however, you get an added discounted cost.
The deductible seems to be a very confusing part of a PPO plan. Your deductible may be something like $5000. If you have any hospitalization or procedures you would be expected to pay the first $5000, before the insurance company shares any cost.
Co insurance is what we are talking about when we say the insurance company will "share " some expenses with you. Your co insurance may be 70/30, up to $2000. So you will pay 30% up to an additional $2000 out of your pocket.
For example, you go to the hospital and your bill is $32000. We already know you have to pay $5000, so that leaves $27000 that you would have to pay 30% of up to the amount of $2000. The insurance company would pick up the rest.
So how does it look on paper? Total medical expense was $32000. Deduct your deductible that you are required to pay of $5000, that leaves $27000. Now your expected to pay 30% of the remains balance since your maximum is $2000, and 30% is $8100, you only pay $2000.
Now if you go to the hospital again in that same year you will pay nothing. Your deductible has been satisfied and your co insurance has been meet for the year. Your total out of pocket of $7000 has been paid.
Hopefully by now you understand the most misunderstood aspect of health insurance PPO's. You will never get another mystery bill in the mail from the hospital and have to call the insurance company asking why.
About the Author:
Call agent Jeff Cline today for cheap car insurance. . He can help you find the best deals. Jeff can also help with your health insurance needs as well. Call Jeff 24 hours a day, anyday @ toll free 866.526.9669.
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