Preferred Provider Organizations (PPO)

Preferred provider organizations differ from HMO plans in that these plans allow you to use any physician when medically necessary. The PPO gives you a list of preferred doctors, and will pay a higher percentage of the costs if you use one of their providers. For example, a PPO plan may pay for 80% of the expenses when you are treated by a Preferred Provider, and only 60% if you are treated by a Non-Preferred Provider. When using a Non-Preferred-Provider you could also be responsible for the expenses billed that are determined to be over customary and reasonable charges.

You will be given choices to make about your insurance options within the PPO system when you enroll. The choices you make will apply to you and any dependents enrolled in the plan. Changes can be usually made once a year in periods called "open enrollment." You'll receive a list of participating medical health professionals, which you can use to find health care. Or you may continue to see anyone you already use that is on the plan.

According to the plan you are in, you may have to pay a portion of the cost for each office or hospital visit, regardless of how much the visit costs. Your portion of the payment is the "co-payment." Also, you may have extra fees for some services like, the emergency room, mental health and chemical dependency services.

After deciding on what coverage is right for you, use the online health insurance questionnaire on InsWeb.com to compare health insurance quotes online.

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