1. What is a PPO?

A PPO, is a Preferred Provider Organization, this is a kind of Health Insurance plan that allows you to visit In-Network and Out-of-Network physicians, hospitals and medical centers without a referral system. More doctors accept PPO medical plans then HMO plans.There is also a difference in price. Depending on if you are on a Group Health Insurance Plan or Individual Plan. With a Group Health Insurance Plan, PPO plans tend to be more per month then HMO plans. With Individual Health Insurance Plans PPO plans are less per month then HMO.

2. What is an HMO?

With an HMO, a Health Maintenance Organization, plan you are assigned to a PCP, primary care physician, who will oversee you and your medical care. Your PCP will refer you to other specialists and other doctors as needed. Co-Pays for HMO plans are less then PPO plans.

3. What is a deductible?

When choosing a medical plan you will have a number of deductible options to chose from, ranging from $250-$8,000. A deductible is the amount you will pay toward medical services before the insurance company will pay your Co-Pay amounts. Before you meet your deductible you will be paying 100% of the Negotiated Rate. You will not be paying bills as if you do not have insurance, the negotiated rate is a rate agreed on by the service provider and the insurance carrier.

4. How does a CO-Pay work?

The CO-Pay is the amount you must pay when you use medical services. Your Co-Pay amount is stated on your policy. Usually a percentage. This can be for blood work, X-Rays, ER visits and when a patient in the hospital. Office visit are stated differently on your plan.

5. Is there a limit where you stop paying Medical Bills?

Every health Insurance plan will have a Stop-loss or Co-Pay limit. This is the most you will spend in CO-Pays for the calendar year. Once have met the stated CO-Pay limit for the year the Insurance Carrier will now pay 100% of your medical bills.