PPO Health Insurance – Is It Better?

What is PPO Health InsurancePPO basically means Preferred Provider Organization. A PPO health insurance plan is offered by an organized health care plan that offer its member a limited choice of hospitals, doctors and specialists and also the ability to seek the services of a doctor or specialist outside the network. The health net PPO member will be reimbursing only 70% of the cost which the member will have to do all the paper work for his claims.The PPO health insurance plans is similar to an indemnity plan in that a PPO enters into an agreement with medical doctors and hospitals to provide medical care to their members which these doctor or hospitals will charge them for a lesser fee for the service they render. Another unique feature of a PPO is the freedom of the insured to consult with any doctor they wish, even from outside the network of the PPO. So if you consult a doctor outside the PPO network you stand to pay more than if you have consulted from within the network also the insured member can make referrals to doctors and also will need to meet the different in charge between what the health insurance plans offers and what the provider of this services charges.The PPO health network provides a wide network of doctors that is very similar to that of HMO. In order to enroll as a proffered provider organization health insurance plan, you will have to pay a monthly premium part of the annual membership expenses and for those who are in PPO health insurance plan through their employer would fund their premiums debited direct from their monthly salaries, and this kind of deduction is from their gross pay before the removal of taxes. Many employers also pay a small portion of their employee medical premium these is a part of the total compensation package offered to their employees, which help to off set the cost of the health insurance plan.Based on the geography location and the insurance company providing the health individual insurance PPO you will find that your own primary health care medical services provider is also a member of the PPO network Office visit and prescription made by the doctor is not as costly as hospital co payment because of hospital or emergencies associated.Why should I choose a PPO health care provider?PPO differ from Health maintenance organization (HMO’s) in the sense the insured who do not use participating health care providers receive little or no benefit from their health insurance plans.Being a Hybrid between traditional indemnity plans and health maintenance organizations, the PPO aims to strike a balance between the two.PPO can also create efficiencies in the health care business. However, PPO require insurance to pay a claim within a certain time frame in order to obtain the PPO discount, and calculating the PPO discount and the insurer paying the PPO’s access fee is an opportunity for delay and mistake in the already complex situation for paying for health care in the United State. PPO have more strength in their relationship with providers, and can still provide benefit to their insured members, but uninsured patient may not be able to obtain their discount even if they pay cash to the insurance company.What are the cost advantages and disadvantages of this plan?Some of the advantages of the PPO plans include the following:
Being a client of a PPO enables you to receive great savings due to the agreements entered between the PPO and the wide network of doctors and hospitals, these doctors and hospitals reduce their fees which is then passed on to insured.
Individuals also enjoy a tax cut; this is so because the premiums due to the PPO are deducted as source to the account of the PPO thereby reducing their taxable income.
Most times a PPO health care subscriber discovers that his own primary care health care provider is also a member of the PPO network.
Disadvantages of the PPO plans are listed below:
Although a PPO subscriber can use the services of any physician of his choice, he still is liable to pay a larger portion of the bill if he chooses to visit a doctor of his choice who is not a member of the PPO’s health insurance plan.
PPO’s create inefficiencies in the health care system.
There is great room for delays and mistakes in health care delivery due to the several steps involved in insurance payment process.
Irrespective of the few flaws of the health individual insurance PPO, the PPO health insurance plan is a good investment for those who care for their wellbeing and the well-being of their family and dependants. So avail yourself today to Health net PPO systems that enable individuals to select the best PPO health insurance plan well suited to their own unique circumstances.