ppo medical plan definition
fa09d19eb20b7990840f86bdb1bcea71
PPO Preferred Provider Organization. A health care organization composed of physicians, hospitals, or other providers which provides health care services at a reduced fee. A PPO is similar to an HMO, but care is paid for as it is received instead of in advance in the form of a scheduled fee.
d6f8e797db5d719e36bb1b3f467bf7a9
Health Insurance Center HMO: An HMO (Health Maintenance Organization) is an organization that provides or arranges for coverage of certain health care services required by members of the organization. Typical HMO coverages include access to a primary care physician, emergency care, and specialists/hospitalization when needed.
8f4e5cf0e17836633688e3de3426f6e1
- Learn the difference between an HMO (Health Maintenance Organization) and a PPO (Preferred Provider Organization) and decide which type of coverage is most beneficial for you and your family.Posted on 1/13/2011 | Comments (). Health Maintenance Organization (HMO) is a type of managed care health plan where members choose their physician from a list of approved health care providers which typically results in lower premiums and/or copayments.
5ece16d4bac27387abc1f2949a680d37
Managed Care Terms Definition. US medical firm, such as an health maintenance organization (HMO) , that delivers quality healthcare through a system designed to enhance efficiencies and reduce costs.
72fe56d9661e8e7294adc6ef3185ffed
Preferred provider organization Exclusive provider organization (EPO) vs. preferred provider organization (PPO) A PPO is a healthcare benefit arrangement that is similar to the EPO in structure, administration, and operation. Unlike EPO members, however, PPO members are reimbursed for using medical care providers outside of their network of designated doctors and hospitals.
eaa81e1be3c1a303ecaba92ddc77dc70
What is PPO Health Insurance? What is PPO Health Insurance? PPO health insurance is a flexible and expensive health care option. It stands for preferred provider option network. The PPO means your insurance company will have a network of care providers available to you at your discretion.
fa0f2071a36ce97b97a6bafacb67661f
Managed Care Terms A generic term applied to a managed care plan; also called Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), Exclusive Provider Organization (EPO), although the MCO may not conform exactly to any of these formats.
f06c9bc5ee92a4df70d9e66ec0d95088
- exclusive provider organization. EPO, A type of managed health care plan that combines features of HMOs and PPOs. it is referred to as exclusive because it is offered to large employers who agree not to contract with any other plan. EPOs are regulated under state health insurance laws.
6ba5bfd6a39f52632753c829c16cdf8e
Health Maintenance Organization Health Maintenance Organization. HMO. A form of health insurance combining a range of coverages in a group basis. A group of doctors and other medical professionals offer care through the HMO for a flat monthly rate with no deductibles. However, only visits to professionals within the HMO network are covered by the policy.
1a67b4552e9f95fa1764c2e48b0e660a
Health Maintenance Organization (HMO) Health Maintenance Organization (HMO). A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO.It generally won't cover out-of-network care except in an emergency. An HMO may require you to live or work in its service area to be eligible for coverage. type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO.
d2aebf47482705ef603cb6bdd7781dc1
PPO Insurance Plans A PPO plan may be right for you if: 1  You want the freedom to choose almost any medical facility or provider for your healthcare needs. 2  You want a portion of out-of-network claims to be covered by your insurance company. 3  You don't want to get referrals before visiting a specialist.
957b650920ec81cc040b55170de786d9
physician-hospital organization physician-hospital organization (PHO), (in the United States) a management service organization in which the partners are physicians and hospitals. The PHO organization contracts for physician and hospital services. Managed care A corporation formed by a hospital and its medical staff to contract with MCOs.See Managed care.in the United States) a management service organization in which the partners are physicians and hospitals. The PHO organization contracts for physician and hospital services. Managed care A corporation formed by a hospital and its medical staff to contract with MCOs. See Managed care.
9a7216d690de5fa01a1a3e1ad848e3ac
PPO Insurance Plans As a member of a PPO plan, you'll be encouraged to use the insurance company's network of preferred doctors and you usually won't need to choose a primary care physician. No matter which healthcare provider you choose, in-network healthcare services will be covered at a higher benefit level than out-of-network services.
82929d94b79682cf424d6275b24fb16b
Preferred Provider Organization (PPO) Plans A Medicare PPO Plan is a type of Medicare Advantage Plan (Part C) offered by a private insurance company.In a PPO Plan, you pay less if you use doctors, hospitals, and other health care providers that belong to the plan's network. You pay more if you use doctors, hospitals, and providers outside of the network. Medicare PPO Plan is a type of Medicare Advantage Plan (Part C) offered by a private insurance company.
67460d1842507f018b707874195255ac
Health Maintenance Organizations and Preferred Provider Organizations Related Terms: Employee Benefits; Health Insurance Options. Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs) administer the most common types of managed care health insurance plans. Managed care plans typically arrange to provide medical services for members in exchange for subscription fees paid to the plan sponsor—usually an HMO or PPO.
c0e71b3d1e35de44dc98e2b32ee7ce5b
- Definitions for common health insurance terms. DEFINITION: A preferred provider organization (PPO) is a managed care organization of health providers who contract with an insurer or third-party administrator (TPA) to provide health insurance coverage to policy holders represented by the insurer or TPA.
9e65b905035ec3da9a66d5b422fcff93
- A health maintenance organization (HMO) and a preferred provider organization (PPO) are both managed care plans. A managed care plan is a method of paying for and providing health care for a set fee using a network of hospitals, doctors, and other health-care professionals.
b69c539c5926d72ba829dae7a528a873
PPO vs HMO Health maintenance organizations (HMOs) An HMO is a managed care organization (MCO) that provides health care services for those on connected insurance plans. HMO-like services began appearing in the early part of the 20th century and they started becoming popular after the Health Maintenance Organization Act of 1973.
58261d730d0969a8d3d7f10b559e61b1
Provider-Sponsored Organization (PSO) Law and Legal Definition The following is an example of a federal statute defining the term: According to 42 USCS § 1395w-25 (d)(1), the term provider-sponsored organization means a public or private entity: (A) that is established or organized, and operated, by a health care provider, or group of affiliated health care providers; PSO is owned and governed by health care providers such as physicians, hospitals, or allied health professionals and not by an insurance company. PSO may be either profit or not-for-profit entities, or public or private entities. PSO through its network, supplies all medical services required by medicare law.
eb73bfecfdb267cd55bb3e7e180ce9ea
HumanaChoice PPO HumanaChoice(PPO). Freedom to choose, ways to save with a PPO plan. HumanaChoice(PPO) ® is a Medicare Advantage Preferred Provider Organization (PPO) plan that gives you freedom to choose which doctors, specialists and hospitals you visit. You can help lower your costs when you use network providers.
4120b58ba924f5d303573baae0394593
Point of service plan A point of service plan, is a type of managed care health insurance plan in the United States. It combines characteristics of the health maintenance organization (HMO) and the preferred provider organization (PPO).The POS is based on a managed care foundation---lower medical costs in exchange for more limited choice. But POS health insurance does differ from other managed care plans.Enrollees in a POS plan are required to choose a primary care physician from within the health care network; this PCP becomes their point of service.t combines characteristics of the health maintenance organization (HMO) and the preferred provider organization (PPO). The POS is based on a managed care foundation---lower medical costs in exchange for more limited choice. But POS health insurance does differ from other managed care plans.
4edf86b4829cbc648820aeac4af48c21
Glossary of Terms A Medicare Advantage (Medicare Part C) PPO plan, or a Preferred Provider Organization plan, is available through a private insurance company contracted with Medicare.PPO plans have their own network of doctors and hospitals.Individuals enrolled in a Medicare Advantage PPO plan are allowed to use out-of-network providers for covered services, but usually for a higher cost.PO plans have their own network of doctors and hospitals. Individuals enrolled in a Medicare Advantage PPO plan are allowed to use out-of-network providers for covered services, but usually for a higher cost.
e4f63cc22a13c45de218ec215746fb16
Preferred Provider Organization (PPO) Plans In most cases, you can get your health care from any doctor, other health care provider, or hospital in PPO Plans. PPO Plans have network doctors, other health care providers, and hospitals.
add8e79c0beef3e933d90cab7d758616
What's The Difference Between HMO and PPO Plans? Two you’ve probably heard of are a Health Maintenance Organization (HMO) and a Preferred Provider Organization (PPO). Generally speaking, the difference between HMO and PPO plans includes the size of the plan network, ability to see specialists, plan costs, and coverage for out-of-network services. Let’s take a closer look at each plan type to see how they're alike, how they differ, and how you can choose the type of plan that meets your needs.
ae2d6074151ce7048a9624646b30a263
HMO - PPO - POS Plans A health maintenance organization (HMO) is a type of managed healthcare system. HMOs, and their close cousins, preferred provider organizations (PPOs), share the goal of reducing healthcare costs by focusing on preventative care and implementing utilization management controls.
f9ab0e401e05debefeedd160884c7c5d
Point-of-Service Plan in Health Insurance A Combination of a HMO and a PPO. Health Insurance. A point-of-service, or POS, plan is a combination of a health maintenance organization (HMO) and a preferred provider organization (PPO). Typically, point of service plans have a network that functions much like a HMO. First, you pick a primary care doctor, who then manages and coordinates your care within the network.