Reader question:

What is PPO medical health insurance?

Jose

Great question.

PPO medical health insurance, also known as preferred provider organization, is one of the strictest forms of medical health insurance plans out there. The other options are the traditional indemnity health insurance plan, which is most flexible; the HMO health insurance plan, which is stricter but not very much; and the POS medical health insurance plan, which is a mixture of the two that ends up being somewhere in between. Standing by itself on a different part of the stage is the PPO medical health insurance plan, which has similarities to the other three, but is all its own.

The very good thing about PPO medical health insurance is that it is cheap. That is the thing that keeps the people it insures within its plan. The cheap premiums and decent co-payments convince people to stay within the network and continue receiving their health care insurance through the PPO medical health insurance plan.

The Good:

• The co-payments are very, very cheap. And I mean very. If you just go for a regular check up, you’re probably going to end up paying your doctor a co-payment of no more than ten little dollars.
• You don’t have to get a referral to go see a specialist. That isn’t an open ended invitation, though. In order to be covered by the policy when go to said specialist, he has to be a part of the PPO network.

The Bad:

• You can go outside of the network to see a different physician, but the coverage doesn’t extend quite as much, and you’ll have to pay for the visit at the time and then send in a health insurance claim to be reimbursed once you get the bill.
• If you do go outside the network, that’s where the deductible comes in. You’ll probably have to pay one, and it’s also true that if the physician that you visit costs more than the ones within the network, you won’t be reimbursed for the difference.

Cheers,

Fashun Guadarrama.