A PPO or Preferred Provider Organization is a segment of health insurance that can be provided by an accredited health insurance company or provider. If you’re already familiar with an HMO or Health maintenance Organization then you have a good start in regards to what a Preferred Provider Organization actually is and can provide to a consumer seeking health insurance. The reason for this is because the Preferred Provider Organization is very similar to an HMO based on the fact that they have contractual agreements with many of the health insurance companies. The biggest difference is based on the fact that the Preferred Provider Organization doesn’t have as many limitations or restrictions when compared to the traditional HMO. Generally speaking this favors the consumer or individual seeking health insurance coverage through a provider’s health plan.
The advantage that a Preferred Provider Organization offers its clients is the ability for them to freely choose their own health care doctor or physician. This is particularly beneficial for an older person that has seen a regular doctor for many years. Naturally a bond of familiarity and trust builds up between a doctor and long time patient allowing for a comfortable feeling to take place during a routine medical appointment. The PPO allows this professional relationship to continue to exist ensuring better medical treatment. However, while the opportunity to seek medical care from the family physician or local doctor sounds nice it does usually mean that a higher out-of-pocket cost will be incurred by the individual consumer, although a referral isn’t normally needed to see a medical specialist.
As you can expect HMO’s are usually much cheaper due to the restrictions they place on who an insured patient can see and how they go about obtaining a referral to a health specialist for additional medical treatment. The PPO does offer more control over the providing of an individual’s health care needs so in this instance your health as opposed to money may be the final determining factor in regards to which health care plan you choose to apply for.
The Preferred Provider Organization’s main goal has been to provider health insurance coverage to large groups at a lower then normal rate or premium. They have been extremely successful at this endeavor by providing better information to the PPO network of doctors and by providing cheaper rates for medical insurance. In fact they were so successful that the PPO was the main driving force behind a dramatic drop in medical expenses throughout the last decade.
Based on the complex nature of the current health care system any plan, such as the Preferred Provider Organization, is a welcome sign of relief for many consumers needing and wanting adequate health insurance coverage at a very reasonable and affordable price.
By: Sharlene Raven
Posts Tagged ‘Medical Treatment’
The Newbie’s Guide To PPO Health Insurance; Part 1
January 25th, 2010Can You Get Health Insurance with a Medical History In the UK?
January 16th, 2010
If you’re looking for a new credit card, your credit history plays a role in whether or not you’re accepted and what interest rate you pay. Health insurance is no different, though the history that is considered when you apply is the one that your doctor keeps.
Health insurance companies are protecting a risk and, like any insurance company, they try to keep the risk’s they insure as low as possible. So, the better your medical history is, the less likely they are to have to pay out a claim on your policy and the lower your premium will be.
Your medical history may also determine what type of private medical insurance you’ll be eligible to get. If you have diabetes, asthma or another chronic, incurable condition, for instance, most private insurers will exclude coverage for anything related to treatment. Some, taking into account the number of other conditions and illnesses for which those are a risk factor, will refuse to insure you at all. In general, that means that if you know you are ill, or that you’ll require medical treatment in the next six months because of a medical diagnosis, you may have trouble finding private health insurance to cover your needs.
There are many private health insurers who do not require a medical history, or only require a very basic one. In general, their policies will exclude coverage for any condition for which you have been treated in the past five years, or another specified period of time. If you remain free of symptoms and require no treatment for that condition for the specified period of time after you become insured, that condition may become eligible for cover again.
If your prospective insurer does ask for a medical history, you should always be truthful and declare everything you are aware of at the time. Any errors, omissions or outright lies in your application could negate your policy entirely. It’s better to have coverage for unrelated illnesses and conditions than to have no coverage at all.
So, should you bother with private medical insurance if you have a pre-existing chronic condition? Most experts would say yes. The NHS is designed to provide care and treatment for chronic conditions like asthma and diabetes. Your private medical insurance would still provide cover for you for illnesses, injuries and conditions that do not arise from your pre-existing chronic condition. In addition, if you have been treated for an illness in the past five years – ulcers, for instance – and have remained symptom free for five years, most policies will cover treatment for that condition if it recurs.
Interestingly, a number of UK private medical insurance providers do offer chronic conditions cover for UK expatriates. Most continental insurers do not exclude chronic conditions in their policies, and UK companies doing business overseas are beginning to follow suit. If you are seeking medical insurance for a period of time abroad, shop around to find one that will cover all of your needs during your time away.
To find out more about private medical insurance and which UK health insurance companies receive the best customer reviews, visit http://www.uk-insurance-index.co.uk/health-insurance-1.html.
By: Gareth Owen