You are here: Home Insurance Health Insurance: ... Advantages and ... Summary
Information about all aspects of finances affected by a serious health condition. Includes income sources such as work, investments, and private and government disability programs, and expenses such as medical bills, and how to deal with financial problems.
Information about all aspects of health care from choosing a doctor and treatment, staying safe in a hospital, to end of life care. Includes how to obtain, choose and maximize health insurance policies.
Answers to your practical questions such as how to travel safely despite your health condition, how to avoid getting infected by a pet, and what to say or not say to an insurance company.

Summary

Advantages:

  • Unlimited Choice of Doctors
  • Premiums
  • Limit on costs

Disadvantages:

  • Out-of-pocket costs
  • Paperwork
  • Benefits

Disadvantages of PPOs

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.

To Learn More

More Information

POS HMOs

Advantages of PPOs

Unlimited Choice Of Doctors : Like Fee-For-Service (Indemnity) plans, there is total freedom of choice of what doctor and other health care provider to see and when, as well as what treatment to receive and where.

Premiums: Premiums are usually less expensive for a PPO plan than a Fee-For-Service plan but more expensive than a managed care plan such as an HMO.

Limit on Costs: If a PPO provider is used, there is no worry that the charge will be higher than the plan allows. Because the provider and the plan have agreed in advance on the fee, you will never pay more than your percentage of the contracted fee. Usual, customary and reasonable is not an issue as long as you use network doctors and facilities.

To Learn More

More Information

HMO