During this time of annual enrollment are you stuck deciding between a PPO and HMO plan? Both offer a network of doctors but there are key differences. Let’s take a closer look at whether a PPO is the right plan for you!
PPO stands for Preferred Provider Organization. In a PPO plan you have a network of doctors who have agreed to provide a service at a certain rate. However, with a PPO plan you also have the option to see a provider outside this pre-set network. You can choose your own provider, specialist or hospital, even without a referral from a Primary Care Physician. In fact, you can skip the PCP all together! This is especially useful for people who travel often. If you find yourself in need of care while traveling, you have the option to see a provider no matter where you are.
While this flexibility is nice, it also puts more responsibility on you to manage your health in the way a PCP would. It’s up to you to decide when you need to see a specialist and how much you are willing to pay for that. You should ask about the costs associated with different services.
A PPO’s flexibility often comes at a higher out of pocket cost than an HMO plan. Monthly premiums as well as copays for office visits may be higher when you visit a doctor outside your network. Staying within your network will save you money because those providers have already agreed to cover your healthcare.
Some PPO plans require you to pay the copay and the medical bill when you visit at out of network doctor. You then file a claim to be reimbursed by your plan.
Is it right for you?
A PPO is a great choice if you want options or need flexibility. It may be useful if you travel often or have conditions that require visits to specialists. At CSG Medicare Pros, we can walk you through each type of plan and help select a plan that fits your needs and your budget. Call today!
CSG Medicare Pros agents are experienced and licensed specializing in Medicare Health Insurance providing Medicare (parts A and B), Medicare Supplemental Insurance, Medicare Advantage (Part C) and Medicare Prescription (Part D) plans. We serve Medicare recipients in every county in Arizona including in the cities of Mesa, Tempe, Chandler, Apache Junction, Phoenix, Gilbert, Tucson, Kingman, Bullhead City, Prescott, Flagstaff, Yuma, Sierra Vista and more. CSG Medicare Insurance Agents are independent, licensed and appointed with multiple insurance carriers to give you a wide variety of choice. For more information, call (480) 635-4050 or (928) 263-8500.