PPO (Preferred Provider Organization)
 

Review of PPO Health Insurance Plans Benefits

  • Doctor Office Visits
    Choice of Office Visit copay options: $10, $20, $25, $30 or $40.
  • Prescription Drug Benefits
    Copay options: $10, $15 or $25 for generic drugs or $20, $25 or $35 for brand name drugs.
  • Accident Coverage
    • Emergency Room Visits
    • In the Doctor's Office
  • Other Benefits
    • Initial rates guaranteed for 12 months.
    • Plans with lifetime maximum benefits ranging from $2 million to $8 million
    • PPO plan options with no primary care physician or
      " gatekeeper ".
    • First dollar accident benefits to $500, $1,000 or $2,500 with zero deductible for treatment of accidental injuries.
    • Routine wellness benefits by PPO network providers: 
            Routine physical exams
            Routine lab
            Prostate screening
            Pap smear
            Mammogram
    • Optional Dental and Vision coverage also available.

Newer more economical PPO copay plans include:

  • Small plan Service Deductibles ranging from $100 to $500 -
    • for each hospital admission or visit to the hospital emergency room
    • for each outpatient surgical facility visit
    • for outpatient testing
    • for outpatient prescription drugs
  • Lower specific individual plan maximum benefit limits -
    • lower hospital outpatient service coverage
    • more limited prescription drug coverage
    • lower yearly total benefit coverage maximums.

 

 
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