Preferred Provider Organization (PPO) Advantage plans offer a broad network of coverage for reduced costs.
PPO plans, like all Advantage plans, function within an established network of healthcare providers. The insurance company providing the coverage works with these places and people to reduce costs. And, compared to other Advantage plans, PPO plans have some of the biggest available networks.
So, when you purchase a PPO plan, you’re purchasing access to this network. You may also receive certain other available benefits depending on what is available in the plan. For instance, many Advantage plans provide limited dental, vision, and hearing checkups and care, as well as Part D coverage.
If you venture outside of the available network, you will have to pay a lot more out-of-pocket. So, when you’re choosing and purchasing an Advantage plan, be sure to consider whether or not the doctors, hospitals, etc. you want are in-network. If someone is not, you may want to either find a new plan that does or see what similar providers are available under the plan. PPO plans, however, have a fairly large range of coverage, so you should have access to many excellent providers.
PPO plans are flexible. The networks they offer are wide, reaching farther out than most other types of Advantage plans. Not only that, but PPO plans also potentially allow for minimal out-of-network coverage. So, if you, for whatever reason, need to go outside of the available network, you may still receive a bit of help with the cost.
Compared to HMO plans specifically, PPO plans are easier to stay within the network and receive care. You do not have to have a primary care physician (PCP) or get a specialist referral.
With a PPO plan, you are paying for more flexibility. This means that they cost a bit more than their popular competition, the HMO plan. These costs refer to what you will pay on a monthly basis, and your potential deductible, not what you pay out-of-pocket when you receive a benefit, as that is virtually the same between the two of them. Premiums and deductibles for PPO plans are, then, higher than HMO plans.
Don’t feel pressured to rush into an Advantage plan, especially if you’re still not sure what you’re looking for. Schwenker Senior Insurance will help you find what you need when you need it, all you have to do is give us a call at 563-579-6116, or email us at jon@schwenkerins.com.
