Today, health care and health insurance are two booming industries. While both aim for providing better services, health insurance in particular aims to offer individuals the choice of planning for inevitable health related circumstances, under which they would have to mete out a large sum of money otherwise. Many health insurance companies today offer various affordable health insurance coverage packages. One of the most prominent types of health insurance in America is the PPO or Preferred Provider Option (Also known as participating provider organization), the other being HMO (Health Maintenance Organizations)
What is PPO Coverage?
As the name rightly suggests, PPO is a preferred provider option. Various health insurance companies have tie-ups with certain PPOs, which in turn offer consumers health care at discounted rates. However, every time the health insurance company uses the PPO network, it has to pay a certain amount as access fee. In addition, the providers regularly negotiate fee schedules and resolution of provider disputes.
PPO plan includes coverage for:
* Infertility treatment
* Maternity care
* Chemical dependency treatment
* Muscle manipulation services
* Out patient hospital services
* Mental Health
* In patient hospital services
* Doctor office visits
* Post-mastectomy reconstructive surgery
In addition, PPO also undertakes preventive care for adult care and childcare. This includes, immunizations, diagnostic tests and physical exams
Benefits of PPO coverage
When you opt for health insurance coverage through your company, you are given the choice between HMO and PPO. PPO health insurance coverage is known for its flexibility. Although, HMO is comparatively cheaper than PPO, PPO health insurance offers customers a choice of hospitals as well as doctors.
When opting for PPO, policyholders do not have to choose a primary care physician. PPOs offer a range of physicians that policyholders can consult as and when required. However, in many aspects PPO health insurance turns out to be very expensive as compared to health maintenance organizations. Moreover, PPO has something called deductible and co-pay. While the former has to be dealt with before the insurance company starts covering the expenses, the later has to be paid for every visit. Deductibles can go up to $5000 for a family and can range from $500-2500 when it comes to an individual.
In addition, when it comes to the physician, the professionals are more likely to prescribe certain medicines to an individual using PPO rather than an HMO. A major reason for this being the financial constraints HMO individuals are more likely to face. Besides, if the insurance company is not ready to pay for some tests, physicians are bound to act very apprehensive since they are taking a chance.
Now that you know important aspects of PPO Insurance Plans, make sure you choose an appropriate insurance plan. While choosing the plan, you will be asked to select the coinsurance limit and the plan deductible. Moreover, while opting for an affordable PPO health insurance coverage, always, make sure the insurance company is financially sound and recognized
Earnest younge writes about natural cures and health insurance issues
