How to compare PPO and insurance plans with high deductibility

If you feel your brain ache because of all the different options for health insurance, then you need to stop for a second and start comparing 2 health plans at once. You can compare PPO and highly deductible plans at the start. Once you narrow down the types of plans to the one that suits you best, then it’s time to compare the health insurers that fit that category. A radical elimination process eliminates the mental stress of choosing a health insurance company.

How to Compare PPO & High-Deductible Insurance Plans
How to Compare PPO & High-Deductible Insurance Plans

Step 1

Know your terms before you begin. Three terms are included in most insurance policies: deductible, coinsurance, and stop loss. Stop loss is the maximum amount you pay for permissible medical expenses. Not all expenses fall into this category, regardless of the insurance plan.

Step 2

Pay everything until you pay the deductible in your insurance plan. Both PPO’s and highly deductible plans have deductions. The amount for these varies according to your choice. The higher the deductible, the lower the premium for that type of plan. Both plans also have a co-insurance clause in them. In a PPO, if you go to a doctor or hospital that is not in the network, you may not have to pay a higher copay, but the insurance company may not pay a large percentage of the bill.

Step 3

Understand what a PPO plan is. The letters PPO stand for Preferred Supplier Organization. Doctors, hospitals, and other health care providers make agreements with the insurance company for the company to offer their discounts.

Step 4

Check out your high deductible insurance plan. The reason for the lower cost for these plans is that they don’t have to pay smaller requirements. With a high deduction, most people do not reach the amount deducted, so the amount they receive only compensates for larger claims, which they have to do regardless of the deduction.

Step 5

With a highly discounted plan, choose any doctor of your choice. The biggest difference between PPO plans and high deductibles, besides upfront out-of-pocket costs, is the choice of a doctor. PPO programs only use their physician network for full credit and pay less if you use a doctor, hospital, or provider that is not in their network. If you find a plan with only a small network of providers in your area, you might consider switching to a high deductible, as the insurance company pays a smaller percentage to out-of-network providers.

Step 6

Consider your past medical history. If you don’t get sick often, consider going with a high deductible. You can start a health savings account with many of them and put that extra money into a tax-exempt account; you can then remove it tax-free if you use it to pay for medical or dental expenses. As the account grows, increase your deductible and reduce the premium.

Step 7

Consider a PPO if you don’t have a doctor, often see a doctor several times a year, or don’t feel comfortable with the concept of paying a large out-of-pocket expense. You need to consider how liberal the high deduction is with the smaller number of invoices for which you are responsible in the PPO. No plan is better; the best plan is the one that suits your needs.

What you need

A copy outlining the coverage for the PPO plan
A copy of the insurance outline for the high-deductible plan
List of PPO priority providers
Past medical bills

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