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Everyone knows the cost of healthcare is rising. Health insurance provides security from serious financial risks that may result from expensive medical bills. That’s why most people try to find a low-cost health insurance plan that will ensure quality medical attention. PPO plans are favored for their flexibility in care and choice. But this freedom can come with a higher cost. You might be wondering “what do I need to know in order to get affordable PPO insurance?

What is a PPO Plan?

First things first, what is a PPO plan? PPO stands for Preferred Provider Organization. It’s a type of health plan that contracts with medical providers to create a network. You pay less if you use the doctors and services in the plan’s network. Doctors, hospitals, and providers outside of the network are still available, but for an additional cost. PPO plans are thought to have more flexibility, because you have the freedom to see any in- or out-of-network doctor or specialist without a referral. You are also not required to have a Primary Care Physician. This flexibility, however, can make PPO medical insurance plans more expensive than HMOs.

What Should You Expect?

While you may desire affordable PPO insurance, you want to have the right expectation going in. First, PPO plans tend to have higher premiums, and it’s common for there to be a deductible and copay. While the ability to use out-of-network services exists, the cost-sharing is higher than using in-network doctors and hospitals. Also, no two PPO plans are alike. Each plan has very different out-of-network coverage. There are some PPO plans that have high cost-sharing for certain out-of-network services and others that do not.

That’s why you want to keep an eye on each plan’s cost-sharing (the premium, deductible, copay, coinsurance, and out-of-pocket maximum) amounts. You also want to take a personal inventory of you and your family’s needs. For instance, if you have a medical need that requires special attention and want the freedom to choose almost any specialist or health facility without needing a referral, a PPO is a good choice for you. This is especially true if you want at least a portion of those out-of-network claims covered by your insurance. On the other hand, if you’re bigger concern is lower monthly premiums, an HMO could be the better option.

A Little Confused?

This is why it’s is best to get some help shopping for affordable PPO insurance. Getting advice from someone who can provide unbiased guidance on these plans, like a HealthMarkets agent, will put you at a major advantage. Plus, we can do cost comparisons and check to see if you qualify for subsidies.

Just look at what Christina from Ashland, MA had to say about us:  

“What a relief to have HealthMarkets. You have an agent who charges you absolutely zero money, presents to you all the different options available to protect you and your family in the most economical way available. It is crazy to try and navigate the new health care system without some guidance from HealthMarkets.”

Give HealthMarkets a call today at (855) 839-8126.


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