Angela Madrigal
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The type of coverage provided by that plan
A Preferred Provider Organization is a
type of health insurance plan that offers coverage through a network of healthcare
providers.
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Are there any deductible, co-pay, and/or co-insurance requirements?
Plans may set their
own deductibles, copayments, and other cost-sharing for services. PPOs typically set
fixed copays for in-network services and may charge more if you see an out-of-network
provider.
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Does the plan require patients to get services within a network?
With a PPO plan, you
have the flexibility to receive covered services from providers that are not in your plan's
network, but your costs will be significantly higher because we do not have negotiated
rates with those providers.
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Does the plan have cost-sharing?
PPO uses cost-sharing to help keep costs in check
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Summarize some of the pros and cons of your chosen managed care plan.
Some pros of
the PPO plan are more flexibility, may offer more services, and no referrals are needed
when someone has a PPO plan. However, the cons are might have an annual deductible,
maybe more paperwork, and other costs to consider.
