Health plans in which certain doctors and hospitals have agreed to participate. They are marketed to employer groups, and fees charged are usually reduced in anticipation of receiving additional patients.
Preferred provider organizations (PPO's) are managed health care insurance programs where patients have a limited amount of choice. They are better and more expensive than HMO's but are not as expensive or as good as indemnity plans. Premium – This is the money that the insurance company charges a patient or their employer to provide coverage for a loss. This is usually a monthly fee. The fee is larger for better insurance like indemnity insurance and is lower for lesser coverage like an HMO.
Health care delivery systems in which hospitals, physicians and other health care providers agree to provide health care services at a discount. A health care arrangement between purchasers of care (e.g., employers, insurance companies) and providers that provides benefits at a reasonable cost by providing members incentives (such as lower deductibles and copays) to use providers within the network. Members who prefer to use nonpreferred physicians may do so, but only at a higher cost. Preferred providers must agree to specified fee schedules in exchange for a preferred status and are required to comply with certain utilization review guidelines.
Health care providers that provide comprehensive health care services to its subscribers within a network of physicians and hospitals.
Type of health insurance program where a limited group of physicians and hospitals provide a broad range of medical care for a predetermined fee; individual who do not use the preferred providers for care usually have to pay a higher portion of their medical expenses.
a group that offers discount health insurance rates that offer doctors from a pre-determined list of professional care givers. If a doctor not included in the PPO plan is selected, the health insurance policyholder must cover the all fees for the medical treatment.
Managed care arrangement consisting of a group of hospitals, physicians, and other providers who have contracts with an insurer, employer, third-party administrator, or other sponsoring group to provide health care services to covered persons.
"PPO plans are usually the most expensive with the lowest benefit amount. The PPO plan has in and out-of-network benefits. There is an array of PPO plans to choose from, such as higher deductible and coinsurance plans, should there be a desire to lower the monthly premiums. Generally, PPOs provide a larger network of Healthcare Providers than a HMO or POS. A PPO plan does not require a Primary Care Physician (PCP) or referrals."
You or your employer receive discounted rates if you use doctors from a pre-selected group. If you use a physician outside the PPO plan, you must pay more for the medical care.
This is a group of health care providers who have agreed by contract to furnish medical services to members of a health plan at discounted rates.