|
|
|
|
|
|
What
Is a PPO?
- A Preferred Provider Option is a network of
physicians, clinics and hospitals that have
agreed to offer medical care at negotiated
prices.
- With PPO insurance plans, the premiums you pay
are less expensive than a comparable plan that
does not use a network.
- You are not required to select a primary care
physician, and referrals are not necessary to
obtain services for specialty care as long as
the providers participate in the network. PPO
networks offer a large selection of physicians
and hospitals.
- Most PPO plans include benefits for an office
co-pay, as well as a prescription drug benefit.
Many plans also offer benefits for preventive
services. No paper work or claim forms are
needed for reimbursement.
- Most individual PPO plans will have a deductible
and co-insurance. Typical charges that apply to
these would be services not billed through a
physician office, I.e., hospital expenses and
lab fees not charged by the physician. Examine
the policy as some plans offer a first dollar
benefit on these procedures.
- Although maximizing your benefits involves using
a participating provider, PPO plans do offer
coverage for certain services even if a
participating provider is not used. However, the
benefits will incur higher out of pocket
expense.
What is an HSA?
A Health Savings Account (HSA) is actually made up of two components:
- A qualified High Deductible Health Plan (HDHP)
- The health savings account
You may use the money in the account to pay for qualified expenses now and in the future. The federal government allows tax advantages for the money you deposit into the account. You can also establish the account with a financial institution of your choice, although many insurance companies have already set up their own administrators for simplicity.
Premiums for an HDHP are lower than that of traditional insurance plans, and can be reduced even more when combining it with a PPO network. The money you save on this premium can be contributed to the HSA and is TAX DEDUCTIBLE. The money in the account can grow tax-deferred, and when withdrawn from the account to apply to your deductible or to pay other legitimate medical expenses, it is tax free. Money that is not used in any give year can be rolled over to the next year- it's your money, and you can't lose it.
The HDHP itself is generally a plan with single deductibles of $1050 and up, and family (shared) deductibles of $2100 and up. Typically, when this deductible is met, coverage for the remainder of the year is 100%, although some companies do offer an 80% benefit to reduce premiums even more.
Higher cost sharing in the form of a higher deductible means a health insurance plan with a lower premium. On most plans, charges for office visits, prescriptions and hospitalization apply to the single or family deductible. The money in your savings account can help to pay that deductible, and many insurance companies offer a debit card along with their HSA plans. Although it is prudent to set up an HSA along with a HDHP, it is not a requirement-some individuals will just use an HDHP as a "catastrophic" plan.
One aspect to bear in mind is when using a PPO network with an HDHP, the discounted network charges are also a benefit to you. As an example, the doctor charges $85 for his visit- your responsibility to go toward your deductible- but because of the negotiated PPO discounts, that fee gets reduced to $60-this is the amount you pay to help satisfy the deductible.
We're Here
for you!
This search engine is an excellent tool to shop
many carriers for your insurance needs. As part of
the quoting process, many plans are listed, and can
cause some confusion. Once you find a plan you like,
click on details for an explanation of the policy.
Likewise, there may be some medical conditions or
history that may have an affect on your actual rate.
Please feel free to contact us via the telephone or
e-mail and we'll be happy to help you.
Do you have other questions?
Call Us! (800) 472-5005
- Plan Questions
- Will they insure me?
- Can I cover my child who's in college?
- Do they cover physicals?
These are all questions we can answer!
|
|
|
|
|
|
|
