Group Insurance Benefits ExplainedGet the details, guidelines, pros and cons, and future outlook of Group Insurance Benefits from the specialists

This is the first in a series of blog posts that will the different group insurance benefits medical plans.

The first type of plan I want to talk about is the Preferred Provider Organization plan, better know as a PPO plan for short – after all, that’s quite a mouthful.

A PPO plan is a more flexible plan and has many advantages:

• It allows you to see any doctor you want.
• You do not have to designate a primary care physician.
• You can usually see any specialist without referral.

A PPO Plan does have some limitations – remember the PP in PPO is short for “preferred provider” and refers to all of the doctors and health care providers that have signed an agreement with the insurance carrier.  When a doctor or health care provider is on the preferred provider list they are considered “in network”. Those not on the list are considered “out of network”.

If the doctor you use is in network it will cost less than if you see a doctor out of network. There are basically two reasons for this. The first is that a PPO sets different deductible payments for in network versus out of network providers.

Secondly, the PPO determines a reasonable cost for each medical procedure and will only pay a percentage of what they decide is a fair cost. If the out of network provider doesn’t agree, you will be responsible for your percentage plus the difference between the bill and what the PPO says is a reasonable cost.

Up next…So Many PPO Plans to Choose From

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