PPO insurance is another type of managed care temporary health insurance. A Preferred Provider Organization plan (or PPO health plan), has doctors and hospitals included in its provider network. Like an HMO, it requires you to pay monthly premiums and covers unlimited health care services. The main difference from other types of short term health insurance plans is that you have more freedom and choice with PPO plans. Affordable temporary health insurance typically requires you to pay a deductible as well as co-payments. Each prescription, doctor visit, or medical lab test per may cost from $10 to $30 each out-of-pocket. Deductibles–which you need to pay before the temporary health insurance coverage kicks in–can be up to several thousand dollars per year, although many short term PPO plans will count your co-pays towards fulfilling that amount.
A PPO short term health insurance plan allows you to have greater control over your health care. For example, you can select any doctor you choose. There is a network of physicians that works with your PPO medical plan, just like in other types of managed care. If you choose a primary care physician within the PPO plan’s network, most of the cost will be covered except a small co-pay. How is cheap short term health insurance possible with a PPO? These plans are able to offer services at a lower rate because they are promised that patient volume will increase; as a result, their total revenue will increase even though each individual service costs patients less. However, short term health insurance coverage will pay for part of the cost of seeing an out-of-network doctor if you so choose; unlike other types of temporary health insurance that stick you with the entire cost. It is less convenient to go out-of-network. You may be required to fill out and submit claims, and you will have to shoulder more cost than you would when seeing a doctor in-network.
In contrast to other types of short term health insurance, “self-referral” is allowed in PPO health plans. This means that you don’t have to wait for your primary care physician (PCP) to refer you to a specialist. Since you don’t need to see your PCP, you will save time as well as the co-payment, leading to more affordable temporary health insurance. You can search for specialists within the PPO insurance plan’s network and make an appointment, regardless. Although you can also see a specialist outside of the preferred network with your short term health insurance plan, it’ll cost far more. While doing so could be helpful for someone with a rare condition requiring special treatment from specialists unlikely to be covered in a PPO health plan, it is always a good idea to compare PPO plans and see if the physicians you want to see are in their networks. Some PPO insurance plans have larger networks than others. It can have a significant impact on your finances. For example, a PPO plan may cover 80% of the cost to see an in-network physician, but will only reimburse 50% of the cost to see an out-of-network one.
In fact, temporary PPO health insurance plans do not require you to have a primary care physician at all! Unfortunately, PPO short term health insurance plan premiums are normally higher as a result. Most likely, you will also have to pay more in co-insurance and co-payments. High-deductible PPOs may result in lower temporary health insurance premiums. Balancing the two is essential. Another surprising pitfall of PPO plans is many only cover the specified percentage of “reasonable costs” for medical treatment. This may be less than actual expenses, especially if you go out-of-network.
Wondering if a temporary PPO health insurance plan right for you? VitalOne can provide you with a short term health insurance quote, and our licensed insurance agents can help you compare coverages.