an indemnity plan where coverage is provided to participants through a network of selected health care providers (such as hospitals and physicians). The enrollees may go outside the network, but would incur larger costs in the form of higher deductibles, higher coinsurance rates, or nondiscounted charges from the providers.
A Preferred Provider Organization plan is an MA plan that has a network of contracted providers that have agreed to treat plan members for a specified payment amount. A PPO plan must cover all plan benefits whether they are received from network or non-network providers. Member cost sharing may be higher when plan benefits are received from non-network providers.
a type of medical plan that features a network of preferred providers. When you elect to receive care from providers in the network, the plan generally provides a higher level of coverage, and may require less paperwork.
network-based plan that encourages members to receive covered services from preferred physicians, health care practitioners or facilities. Members may elect to use non-preferred physicians, health care practitioners or facilities but generally will have higher out-of-pocket costs and more administrative tasks if they do.
A type of Medicare Advantage Plan in which you pay less if you use doctors, hospitals, and providers that belong to the network. You can use doctors, hospitals, and providers outside of the network for an additional cost.
PPO) This Medicare Advantage product offers members the choice of in or out-of-network care, offering a discount for in-netowrk treatment. For more information on PPO Plans, click here
A plan that provides benefits in an indemnity fashion, but pays a higher percentage of the cost of services if patients use a PPO-network provider than if they use non-PPO providers.