A Guide to PPO Health Plans
Health insurance comes in many forms and PPOs are a more flexible, but expensive version. Here is a quick guide to PPOs.
The biggest difference in managed care insurance policies and the more common group health plans of the past is the freedom to select your own physician or specialist without this decision impacting your coverage. The growth of managed care health insurance policies can be directly attributed to rising medical costs and the attempts to control them. Under a managed care program, a system of health care networks was established. Within the network, there would be standard and customary charges.
A Preferred Provider Organization, or PPO, is a type of managed care insurance plan that addresses this desire to retain some say in the choice of a physician or specialist. The PPO gives you a choice to use their network, but allows you to select a physician of your own choice also. The costs of using the network would be much less and this is the incentive to do so. If you go out of the network, you will pay much higher costs. These would be in the form of higher deductibles and co-insurance payments.
The PPO supports preventive care as do most insurance plans today. However, even with preventive care, there may be a co-payment required. This co-payment would be higher outside the network and much lower inside it. This is the whole thrust of the rate structure in a PPO. It attempts to make the option of seeking all your medical care within the network the most attractive. At the same time, it allows you to exercise your own choice as long as you are willing to pay the extra costs.
When considered a PPO, it is important to understand the size and the location of the network. If the network appears large enough and local enough to meet your medical needs, the PPO might be a very good option. When you have a PPO, however, and are estimating your yearly cost of health insurance, make sure that you remember that the cost may be more than just your yearly premium should you opt to go out of the network for care.
Despite what may sometimes be a higher yearly cost, the PPO is extremely popular. The freedom to choose just the right doctor is important to many people. At the same time, the costs are lower when staying within the network. This double approach makes the PPO a good choice. A PPO is often the best selection for a small business owner or self-employed worker because of its flexibility.
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