Preferred Provider Organization PPO

With a PPO, you may have:

• A moderate amount of freedom to choose your health care providers — more than an HMO
• Higher out-of-pocket costs than an HMO
• More paperwork than other plans if you see out-of-network providers
• The ability to manage your own health care

What doctors you can see. Any in the PPO’s network. You can see out-of-network doctors, but you’ll pay more.

What you pay.

• Premium — Your monthly payments are based on the negotiated rates PPOs have with their network providers.
• Deductible — Some PPOs may have a deductible. You may have to pay a higher deductible if you see an out-of-network doctor.
• Copay or coinsurance — A copay is a flat fee, such as $15, you pay when you get care. Coinsurance is when you pay a percent of the charges for care, such as 30%.
• Other costs — If your doctor charges more than others in the area do, you may have to pay the balance after your insurance pays its share.
• Paperwork involved. There’s little to no paperwork with a PPO if you see an in-network doctor. If you use an out-of-network provider, you’ll have to pay the provider. Then you have to file a claim to get the PPO plan to pay you back.

Read more:
Source :  http://article.shoppingcenterreview.com/preferred-provider-organization-ppo/

Top things to know about choosing a insurance plan

Just because it is the most expensive plan doesn’t mean it is the right one for you. Not everyone needs a “Cadillac plan,” Harte says. Less than 10% of the population is admitted to the hospital every year.

Look at what you spent last year. If you notice you didn’t go to the doctor very much, or didn’t get a lot of prescriptions, and you have some savings, pick the plan with the less expensive premiums. The deductibles will likely be higher, but even if you have to visit your primary care physician once or twice, it’ll probably still be cheaper. Plus, with Obamacare, all plans that are not grandfathered in will cover preventive health services, whether you meet your deductible or not.

Each insurance brand may offer one or more of these four common types of plans:

• Health maintenance organizations (HMOs)
• Preferred provider organizations (PPOs)
• Point-of-service (POS) plans
• High-deductible health plans (HDHPs) linked to health savings accounts (HSAs)

Here are 6 things to consider before choosing a health insurance plan:

1. The category you choose affects how much your premium costs each month and what portion of the bill you pay for things like hospital visits or prescription medications. It also affects your total out-of-pocket costs.
2. Plans in all categories offer the same set of 10 essential health benefits and the categories do not reflect the quality of care the plans provide.
3. When choosing your health insurance plan, keep this general rule of thumb in mind: the lower the premium, the higher the out-of-pocket costs when you need care; the higher the premium, the lower the out-of-pocket costs when you need care.
4. Think about the health care needs of your household when considering which Marketplace insurance plan to buy. Are you likely to need a lot of care? Or a little?
5. If you can’t afford health insurance, you may be able to get lower costs on your monthly premium. You may qualify for lower out-of-pocket costs for copayments, coinsurance, and deductibles.
6. Other options like Medicaid or the Children’s Health Insurance Program (CHIP) may be available to you. The Marketplace also offers catastrophic plans to people under 30 years old and to some people with very low incomes.