Why you need a PPO policy
With the rising cost of hospital bills and premiums, it is now more important than ever to ensure that your health insurance policy gives you full coverage. If you want a limit on your Out-of-Pocket exposure as well as being able to choose what doctor, physician or surgeon sees you, then you are going to want a health insurance policy with PPO coverage.
Too many people are led to believe that their HMO or EPO policy will cover them as long as they go to a hospital that is In-Network. What you may not know is that there can be doctors at that In-Network hospital who are Out-of-Network (OON). When you go to a hospital you do not have a choice as to what doctor or specialist will be seeing you. There may be many doctors who help treat you and each one is going to send you a bill. If any of these doctors are OON, even if you are at an In-Network hospital, the entire bill for the OON services will be your responsibility and there is no limit for how much it may cost.
On top of having an unlimited liability, the other main issue with HMO and EPO policies are that members are stuck in a network of hospitals. This means that your policy may not cover you in the event that you needed to go to the best hospitals in the nation such as Memorial Sloan Kettering Cancer Center, Hospital for Special Surgery, Mayo Clinic and Children’s Hospital of Philadelphia to name just a few. If for whatever reason you need any kind of medical help or treatment, you are going to want to see the best doctor, physician or surgeon you can find.
The whole purpose of health insurance is to put a limit on how much you may be liable for. A policy that doesn’t limit your Out-of-Network responsibility is insufficient and doesn’t do what insurance was created to do. If you are paying thousands of dollars each year for a policy that doesn’t have a limit on your Out-of-Network exposure, you should really find out what other options may be. If you would like to speak with a licensed agent, we can help you compare policies from different providers to find out which one works best for you.