individual health insurance option

A Participating (or Preferred) Provider Option (PPO) is a form of health insurance. Simply put, this type of plan extends higher levels of benefits when members choose to obtain services from participating (preferred) providers.

A PPO or Preferred Provider Organization is a group system of health care organized by an insurance company. All types of physicians, health care providers, hospitals and clinics sign contracts with the PPO system to provide care to its insured people. Blue Shield of California, Blue Cross of California, Blue Cross Blue Shield of Arizona Health Option One & Option Twelve. These medical providers agree to accept the PPO’s fee schedule and guidelines for its managed medical care.

The insured members pay a co-payment at the time of each medical service. For example, at the time of an office visit to a physician, the patient pays $10. Out of pocket expenses can and do apply. Each person will also have a yearly deductible to pay out of his/her pocket, before the insurance company will start paying medical fees. Affordable Health Insurance that is right for you at Humana-Onecom. The insurance usually pays a percentage of the medical fees (often 80%) for the in-network doctor, with the patient responsible for the remainder of the bill. If the person wants to see an out-of-network doctor, he/she may do so without permission; but the deductible for out-of-network services may be higher and the percentage the insurance will pay may be lower. In other words, the patient will be responsible for a greater part of the fee. This encourages the people insured with a PPO to use the physicians, other medical providers and hospitals in their network.

Advantages of a PPO include the flexibility of seeking care with an out-of-network provider if so desired, even though it is more out-of-pocket expense for the patient. California Agents must show you an illustration of the effect of inflation on the cost of LONG TERM CARE-2.