California PPO Plans
Picking the right type of health insurance policy for your situation is, perhaps, even more important than picking the right health insurance provider. California PPO plans are one of many options available for those seeking insurance, either as an individual or as part of a small company. PPO is one of the three major types of policies available; the others are the HMO (which stands for health maintenance organization) and POS (point of service). PPO stands for preferred provider organization. This type of insurance gives you far more flexibility when choosing a health care provider. POS plans combine some of the features of each of the other two, but are a far less common option.
PPOs and HMOs differ in quite a few ways. HMOs require that you pick a primary care physician that is a member of their network. This primary care physician is your gateway any other care you require. You cannot see other doctors without first getting a referral from your primary care physician. If you buy an HMO policy and your current doctor is not part of their plan, you will have to find a new one who is in order to have your visits to the doctor covered. By contrast, PPOs let you choose who you want to see. Under a PPO, you are not required to designate a primary care physician.
Instead, under your PPO policy, there will be a list of preferred providers. When you visit a preferred provider, you will only be responsible for paying your deductible and co-pay. If you wish to see a provider who is not part of your insurance company's preferred network, you can still get the visit covered by your insurance. Usually, it will cost more to see someone outside your insurance network. You will also usually have to pay for the visit yourself and then file a claim so that your insurance company can reimburse you for the portion of the cost that they cover.
California PPO plans also allow you to choose when to see a specialist. To get a visit to a specialist covered under an HMO, you will need to get a referral from your primary care physician. It is also necessary to get a referral for diagnostic tests such as xrays. Under PPOs, these limitations do not exist. You can decide, independently, if you need the care of a specialist such as an allergist. As a result, you far more control over your health care decisions. However, you may still be required to get a referral before having especially expensive procedures.
One of the drawbacks of a PPO is that, in general, this sort of plan is more expensive than an HMO. However, many people find that HMOs are too restrictive to be considered a good option for their healthcare needs. To find out what sorts of plans suit your needs best, it is important to compare the benefits and costs of each. Our website allows you to compare the costs of policies from a number of different companies so that you can choose the policy that best fits the needs of you and your family.