A PPO is a type of health insurance plan where members are encouraged to use in-network healthcare providers who have agreed to charge reduced, negotiated rates. Members can visit any doctor without a referral but will pay less when using in-network providers. With a PPO, members are responsible for paying an annual deductible and may have copays or coinsurance. A PPO may be suitable for individuals or small businesses whose employees need flexibility in choosing doctors and do not require referrals to see specialists.

1. What is a PPO?
PREFERRED PROVIDER ORGANIZATION
ANGELA CARRIER, PRINCIPAL OF FINANCIAL & BENEFIT SERVICES COMPANY

2. Preferred Provider Organization (PPO)
 With a PPO plan, employees are encouraged to use a
network of preferred doctors and hospitals.
 These providers are contracted to provide service to
plan members at a negotiated or discounted rate.
 Employees generally aren't required to designate a
primary care physician, but will have the choice to see
any doctors or specialists within the plans network.

3. PPO Deductible & Copay
 Employees have an annual deductible they'll be required to
meet before the insurance company begins covering their
medical bills.
 They may also have a copayment for certain services or a
co-insurance where they're responsible for a percentage of
the total charges of their medical expenses.
 With a PPO, services rendered outside of the network may
result in a higher out-of-pocket cost.

4. Who Would Like the PPO Option?
 A PPO may be a good option for Individuals/families or your
small business if your employees:
 Need flexibility when choosing physicians and other
providers
 Want the burden of obtaining a referral to see a specialist
 Like the balance of greater provider choice versus lower
premiums

5. With a PPO You May Have:
 Premium: This is the cost you pay each month for insurance.
 Deductible: Some PPOs may have a deductible. You will likely have to
pay a higher deductible if you see an out-of-network doctor.
 Copay or coinsurance: A copay is a flat fee, such as $10, that you pay
when you get care. Coinsurance is when you pay a percent of the charges
for care, for example 20%.
 Other costs: If your out-of-network doctor charges more than others in
the area do, you may have to pay the balance after your insurance pays
its share.

6. What About
Paperwork?
 THERE'S LITTLE TO NO
PAPERWORK WITH A PPO IF
YOU SEE AN IN-NETWORK
DOCTOR.
 IF YOU USE AN OUT-OF-
NETWORK PROVIDER, YOU'LL
HAVE TO PAY THE PROVIDER.
 THEN YOU HAVE TO FILE A
CLAIM TO GET THE PPO PLAN
TO PAY YOU BACK.

7. “
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To learn more about a new plan or review of your
existing plan give me a call!
Angela Carrier, Principal
Financial & Benefit Services Company
Email: acarrier@financialandbenefitservices.com
Cell: 724-941-8772