According to the Kaiser Family Foundations employer health benefits survey, 49% of covered workers have PPO plans.
Compared to only 16% of respondents having an HMO plan. It is clear which health plan is preferred by workers.
So, what is a PPO health insurance plan? Keep reading this guide to learn some of the essential things to know about the PPO health care plan.
1. What is PPO
A PPO plan stands for Preferred Provider Organization and is a type of managed health care plan.
PPO insurance was designed to provide you maximum benefits at an in-network provider, while also providing flexibility with some out of network providers. They are similar to a Health Maintenance Organization (HMO) but have more flexibility around them.
2. Flexibility
With a PPO plan, you are free to receive care from any provider, whether they are in-network or not.
This means you visit specialists, hospitals, and doctors without the need to visit your primary care physician first.
The flexibility to visit other doctors is an important attribute to have, especially when traveling.
3. Cost
Due to the flexibility associated with the PPO health care plan, it also comes at a higher price.
This means higher monthly premiums, and when visiting doctor’s offices, the copay will also be higher. On top of that, there is an annual deductible you must meet before the health insurer starts paying.
PPO plans are a more costly option when it comes to health care plans but provide superior service.
4. Network
Just like HMO plans, PPO plans also have a network of providers to save on health care costs. These providers have an agreement with insurers that they will accept lower payments to be included in the network and have access to patients within the network.
PPO networks do provide some coverage for out of network providers, but you will end up paying more for these services. You will get the lowest costs when staying in the network.
5. Primary Care Physician
With PPO insurance, there is no need to select a primary care physician. You can visit any health care professional without the need for a referral.
Though, as previously stated, staying inside the network will be less costly and will provide full coverage.
6. Premiums
PPO plan premiums are typically more expensive than HMO plans. When comparing the two programs, the difference is slight.
According to the Kaiser Family Foundation health benefits survey, the average monthly premium paid by firms for a single person was $596 and for a family was $1,694. Compared to an HMO plan, the monthly premium paid was $572 for individuals and $1,620 for families.
7. Is It Right For You
When it comes to deciding which health care plan to choose, the options can seem overwhelming.
Remember, it is crucial to keep in mind if you are looking for more flexibility, a PPO health insurance plan may be a good option for you.
If you are looking for lower costs, then it might be a good idea to check out other plans.
Looking for PPO Health Insurance?
Now that you know what a PPO health insurance plan entails, it is essential to remember that your selection will depend on your needs.
If you are looking for a health insurance plan, contact us today. We can help you decide which option is best suited for you.