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The PPO explained

So many people get frustrated because they get surprise bills from a hospital visit or a procedure because they do not understand their PPO plan. We will help you understand the most misunderstood features of a PPO plan.

Consumers prefer the PPO over the HMO, due to the freedom it gives the consumer. You have the choice to go to any physician you wish. However, if you go to a physician that is in the PPO network you will get a discounted rate.

Most people get confused when it comes to their deductible. If you have a $3000 deductible you will be responsible for paying that out of your pocket before the insurance company will share any cost with you.

Now I bet you are confused about he phrase "shared cost". Sharing the cost is the co insurance. This is when the insurance split some of the expenses with you, often 80/20. So you may be required to pay 20% up to $2000 after your deductible is meet.

For example, you go to the hospital and your bill is $32000. We already know you have to pay $5000, so that leaves $27000 that you would have to pay 30% of up to the amount of $2000. The insurance company would pick up the rest.

So let's do the math. Your bill is $30,000. You pay $3000 (deductible ) leaving a balance of $27,000. Twenty percent of $27,000 is $5400. But since you are required to pay 20% up to $3000 you would only pay $3000, leaving the insurance company to pay $22,000.

In that same year, since your total out of pocket (deductible=co insurance) has been meet you would not pay anything if you had to go to the hospital again. Let's say in a year you never go to the hospital or have any treatment, well then you pay nothing.

You should now what to expect the next time you have to go in the hospital or have some sort of procedure done. Never again will you get a bill with a balance you do not understand. No more frustrations.



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Article by: JeffCline | Total views: 143 | Word Count: 361

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