A Preferred Provider Organization (PPO) is a managed care product. It is health insurance available to consumers that have structured benefits and a professional network of medical professional.
Even though a PPO encourages its members to stay in network by promising a negotiated rate or contracted rate you have the freedom to see any professional you would like and still get some benefit.
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.
All of your incurred medical expense will go towards the deductible. If you met this in a year the insurer will then share the expenses with you. They pay 100%. More often the have a co insurance amount to met. They may split expenses 80/20 at this time. You would pay 20% and they would pay the 80% that remains.
Your annual deductible + your annual co insurance amount are called "annual out of pocket maximum. So if you have a deductible of $2000, plus co insurance of $3000 you would pay $5000 annually before the insurance company paid 100% of your medical expenses.
Another way a PPO helps offset some of your out of pocket expense is by offering a co-payment. A co-payment is specific dollar amount you will pay for specified medical treatments. The most common co-payments are seen with an office visit or prescription medication.
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.
You will need to become familiar with all of the facts in regards to a PPO product. Compare all the facts with your needs and budget before deciding if it is for you. This article has covered some of the basics, but there is more to know.
Even though a PPO encourages its members to stay in network by promising a negotiated rate or contracted rate you have the freedom to see any professional you would like and still get some benefit.
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.
All of your incurred medical expense will go towards the deductible. If you met this in a year the insurer will then share the expenses with you. They pay 100%. More often the have a co insurance amount to met. They may split expenses 80/20 at this time. You would pay 20% and they would pay the 80% that remains.
Your annual deductible + your annual co insurance amount are called "annual out of pocket maximum. So if you have a deductible of $2000, plus co insurance of $3000 you would pay $5000 annually before the insurance company paid 100% of your medical expenses.
Another way a PPO helps offset some of your out of pocket expense is by offering a co-payment. A co-payment is specific dollar amount you will pay for specified medical treatments. The most common co-payments are seen with an office visit or prescription medication.
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.
You will need to become familiar with all of the facts in regards to a PPO product. Compare all the facts with your needs and budget before deciding if it is for you. This article has covered some of the basics, but there is more to know.
About the Author:
Are you looking for a PPO health insurance policyagent Jeffrey Cline can help. Are you looking for Nevada Health Insurance or any other State he can help. For budget friendly Temporary Health Insurance he has solutions 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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