If your PCP cannot treat the condition, they can refer you to a specialist in the plan’s network. Health maintenance organizations (HMOs) are health plans in which you have to see your primary care physician first for any health problem. What is an HMO (health maintenance organization)? You can seek medical care from doctors and hospitals outside the PPO plan network (an out-of-network provider), but it will result in higher healthcare expenses and out-of-pocket costs. If you sign up for a PPO, your medical costs are less if you seek medical care from healthcare providers in the plan’s network (this is called an in-network provider). Meaning, a PPO healthcare plan creates a network of participating health care providers. What is a PPO (preferred provider organization)?Ī preferred provider organization plan (PPO plan) is a type of health insurance plan that contracts with specific healthcare providers (doctors and hospitals). Monthly Premium: This is what you pay every month for your healthcare coverage.ĭeductible: This is what you will have to pay out-of-pocket for health services before your insurance provider starts to cover medical expenses. Continue reading to learn more about HDHP and PPO, including the health benefits, out-of-pocket limits, and medical costs associated with each of them. PPO is a critical decision that will affect your monthly premiums, healthcare costs, and access to medical care in the coming year. Do you pick a PPO (preferred provider organization)? Or should you go for an HDHP (high deductible health plan)? And what exactly is an HSA (health savings account)? Whether employed or choosing a health insurance plan on the marketplace, open enrollment can feel a bit overwhelming and sometimes confusing.
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