All About PPOs

The Basics About PPO Plans

Health insurance plans for individuals and families are sold in a variety of plan types.  The most advantageous plan that allows for the broadest based access to providers is a PPO insurance policy.

In vs. Out of Network

PPO stands for a “Preferred Provider Organization” and, this type of network allows for you to see any provider in the network for a reduced fee known as a contracted rate.  What really makes the PPO plan remarkable in terms of provider access is the ability for the policy holder to even see providers that are not contracted and “in network”. Using out of network providers is allowed but the insurance carrier would pay at a reduced rate and you would end up owing more to the provider than you would in network.

This freedom to see any provider in or out of the network is truly the hallmark of PPO insurance and is why it is the most sought after insurance plan on the market.  If you or a family member were to come down with a dreaded disease or illness you could literally see any provider across the country with a PPO plan.

PPOs vs. Other Insurance Plans

This is certainly not the case with other types of insurance networked plans like HMO’s and EPO’s.  With HMO and EPO insurance you must see a participating provider in order for the insurance carrier to pay benefits. Otherwise, if the provider is not in the HMO network, the insurance carrier will not pay any benefits whatsoever!

Another alarming issue when it comes to HMO networks is the provider choices tend to me much more limited than their PPO counterparts.  Many providers in Texas and other states refuse to accept HMO’s simply because the reimbursement amounts are so low they cannot afford to provide services at a profit.

EPO Networks

There are a few EPO networks that are favorable however.  One in particular is United Health Care’s “Choice Plus” EPO network for their new Short Term Plans in Texas and many other states.  This network is identical to the PPO network UHC has had established for many years. The only difference is EPO plans do not pay any out of network charges on your behalf like a PPO will.  

The bright spot with this network is there are over 800,000 participating providers across the county which should give you adequate access to some of the best and brightest doctors in the country.  

Get Help with PPOs and Other Plans

If you’d like to look at any of these short term plans please click the following link. Here you’ll be able to view plans, pricing, and be able to download an outline of coverage for your review before speaking with one of our agents.  However, if you have immediate questions do not hesitate to call us or fill out a contact form for one of our licensed insurance agents to call you at a time when it’s most convenient.

We offer PPO and Short term medical insurance in Texas, Oklahoma, New Mexico, Arkansas, Tennessee, Louisiana, Arizona, and Colorado.

LINK TO SHORT TERM PLANS: https://www.quotit.net/eproIFP/webPages/infoEntry/InfoEntryZip.asp?insuranceTypeID=T&license_no=7EXXNH