Tuesday, August 23, 2011

whats the difference between a premium, standard and PPO health insurance coverage?

premium cost is $130, standard is $120, PPO is $303 a mo. annual out of pocket on premium is 3000 family, PPO is 4000 family, lifetime max is none on premium and unlimited on PPO...I don't understand the difference because everything else is pretty much the same...the premium has lower overall costs or no charge and lower co-pays...why? and it costs less per month than the PPO?
--------------------
Darling, this is an extremely loaded question! I processed health insurance claims for CIGNA healthcare for two years, and I can tell you that although they all "look" the same, they are probably all very different. First, your major concern is whether or not any of them are managed healthcare (HMO). It is a horrible form of healthinsurance and all of the class action lawsuits against it will back me up. Additionally, are you looking at what kinds of benefits are handled by third party vendors. This is sometimes called "carving out" or repricing benefits for things like: vision, dental, labs, x-rays, and the BIG ONE! mental health. Moreover, you need to see what kinds of providers accept these different kinds of insurances. Are there contracted providers? Contracted providers have to take what they get from your insurance and then call it quits; they cant decide to come after you for the balance. (If they do, thats called balance billing and could cost them big time.) If they dont have any/many contracted providers, then whoever you see can chose whether or not to balance bill you. If you have specific questions and want to contact me, please feel free. It is important that you purchase healthcare that is going to be there for you when you need it, and try to minimize buying something that you dont need, all at the same time.
Source

No comments:

Post a Comment