Introduction
This Section Is For Individuals Without Medicare
A preferred provider organization or PPO is
an independent company that contracts with
hospitals, physicians, clinics, chiropractors,
chemical dependency facilities, laboratories,
medical equipment suppliers, mental health
agencies, and a number of other provider types.
This network of providers provides you and
your dependents with efficient, cost-effective
care in exchange for the plan's participation in
the network.
Although you may receive care from any
licensed provider covered by this plan, your
benefits are enhanced if you receive care from a
preferred provider. Preferred providers offer the
following important advantages:
- When you use a provider from the preferred
network, you do not pay the additional $10
office visit copayment required when a nonpreferred
provider bills an office call.
- When you use a hospital or other facility
from the preferred network, you do not pay
the $200 inpatient copayment required
when a nonpreferred facility bills an inpatient
admission.
- Most preferred providers discount their
services which means less out-of-pocket
expenses. Failure to use a preferred provider
may also result in a reduction of benefits.
A direct billing and payment system between
this plan and the provider or facility
eliminates most paperwork.
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