What benefits can I get if I switch to a Blue Shield PPO insurance plan? I have an HMO insurance group health plan but I am limited to seeing other doctors not in the list the insurance company provided.
However, with Blue Shield PPO, your deductibles and out-of-pocket expenses are higher as compared with your current HMO insurance plan especially when you use out-of-network health care services. For example, if you decide to use in-network services, your health insurance plan will pay about 80% of most of the covered costs as indicated in the policy. A doctor’s visit may cost around $20 depending on the type of health insurance plan you choose. This out-of-pocket payment is separate from a yearly deductible which is usually higher than those with HMO insurance plans. Another benefit of this plan is that Blue Shield PPO will file the claim for you, thus saving you the trouble of endless paperwork that you usually experience in your HMO plan. If you choose an out-of-network provider in a PPO plan, your deductible is higher compared with that of in-network provider plans. Your policy will pay 60% of the covered expenses based on the allowed amount indicated in the plan. Also, you must file the claim with the insurance carrier before you can reimburse the out-of-network rates. Another benefit you have with Blue Shield PPO is that you can use your prescription drug benefits through Blue Shield’s in-network pharmacies. Answer by general public - June 26, 2009 @ 3:14pm No CommentsNo comments yet. Leave a comment |
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Blue Shield PPO plans offer more flexibility in choosing health care providers albeit at a higher cost. You have the option to use in-network or out-of-network services and consult with any licensed doctor you wish to see.
