PPO PLAN

PPO PLAN

PPOs give policyholders a financial incentive — reasonable co-payments (also called co-pays) — to stay within the group's network of practitioners.

PPO advantages:
• The standard co-payment is $10 for a routine office visit during regular hours.
• Individual may go to any specialist without permission, as long as the doctor participates in the network.

PPO disadvantages:
• If individual see an out-of-network doctor, he may have to pay the entire bill himself, and then submit it for reimbursement.
• Individual may have to pay a deductible if he chooses to go outside the network, or pay the difference between what network doctors vs. out-of-network doctor’s charge.