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Advantages and Disadvantages Of A PPO

Disadvantages of PPOs

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Patient Out-of-Pocket Costs

  • Although PPOs have less expensive premiums than indemnity plans, they have more than managed care type plans such as HMOs, or POS plans.
  • If non-network providers are used, the other out-of-pocket costs would be the same as under an indemnity plan.
  • If network providers are used, the deductible is usually lower as your share of co-insurance payments.

Paperwork

  • The amount of paperwork depends on whether you are using non-network or network providers.
  • With non-network providers, there is no difference from the indemnity type health plan. Paperwork will be less with contracting providers, but there will still be an Explanation of Benefits to show how much you owe the provider.

Benefits

  • Only a few preventive services are covered. Even those are only covered if provided by contracting health care providers.

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POS HMOs

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