Table of Contents
What does PPO coverage mean?
preferred provider organization
PPO stands for preferred provider organization. Just like an HMO, or health maintenance organization, a PPO plan offers a network of healthcare providers you can use for your medical care. These providers have agreed to provide care to the plan members at a certain rate.
How do I know if I have a PPO or HMO?
The key difference between HMOs and PPOs is that a PPO plan is more flexible and allows you to see healthcare providers both inside and outside your plan’s network, while an HMO plan only covers in-network treatment (with exceptions detailed below).
Is Aetna a PPO?
With the Aetna Open Choice ® PPO plan, members can visit any provider, in network or out, without a referral. But when they stay in network, we’ll handle the claims and offer lower, contracted rates.
Is a PPO plan?
PPO, which stands for Preferred Provider Organization, is defined as a type of managed care health insurance plan that provides maximum benefits if you visit an in-network physician or provider, but still provides some coverage for out-of-network providers.
Can an individual get PPO insurance?
PPO plans, or “Preferred Provider Organization” plans, are one of the most popular types of plans in the Individual and Family market. PPO plans allow you to visit whatever in-network physician or healthcare provider you wish without first requiring a referral from a primary care physician.
How do I know which Aetna plan I have?
The best place to find details about your coverage and benefits is your secure member website. It takes only a few minutes to register. And you only need your member number, which is on your Aetna ID card. You can still get benefits and coverage information by calling the number on your ID card.
Is Aetna a good insurance?
We award Aetna 4.0 out of 5.0 stars. Aetna is one of the largest health insurers in the US, and is highly rated by AM Best and the BBB. The company offers a variety of health plans for employer groups, and a limited number of plans (Medicare supplements, dental plans) for individuals and families.
What is the disadvantage of a PPO?
The most significant disadvantage for a PPO plan, compared to an HMO, is the price. PPO plans generally come with a higher monthly premium than HMOs. So, unless you’re a person who sees a lot of specialists, a PPO plan could cost you more money over the course of a year.
Does PPO have copay?
In general, PPO plans tend to be more expensive than an HMO plan. If you choose a copay PPO plan, you will have to pay a copay (a fixed dollar amount) each time you visit a provider. Generally, a PPO plan with a copay has lower premiums than a comparable non-copay plan.