Oklahoma OK Group Health Insurance
Reader’s Question:
What is a PPO? What are its advantages and disadvantages? I live in Oklahoma.
Billy
Lawton, OK
Thanks for asking, Billy.
PPO plans are usually group health insurance plans in Oklahoma which normally offer a good balance between affordable cost and choice of doctor for its policyholders. I think it can be considered as a cross between fee-for-service health insurance plan and an HMO. While the fee-for-service health insurance plan focuses on choice of doctors, the HMO has focus on low overall cost. PPO plan uses a network of providers (doctors, hospitals, other healthcare providers) to give you health services at low prices. With PPO, you will have the liberty to choose from a greater choice of doctors with the ability to receive care from any doctor or hospital outside the plan’s network at a higher cost to you. The disadvantage I think is having you pay more if you choose to consult a doctor that is not within the listed providers, or if you choose to avail of medical services from outside hospital or health provider (called out of network providers). Using out-of-network providers for a PPO plan does not only cost you more, it can also result to much paperwork than the HMO plan. Like a fee-for-service plan, a single physician will not manage your care in a PPO health insurance plan.