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Author: MetroChick Big funky green star, 20000 posts Top Recommended Fools Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: of 311083  
Subject: Re: Want to Remain Debt Free in 2014 Date: 1/25/2014 10:37 AM
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So my new PCP refers me to an ortho and sports medicine clinic. I look them up and learn they are not in network. But I thought PPOs meant you have more choices than a HMO. Yes, but they are not all affordable choices.

Most PPO have their own websites where you can look up specialists to see if they are in-network or out-of-network. Your PCP probably doesn't know what other doctor's offices are in-network for your insurance plan. With a PPO, going to an in-network doctor means there will be lower co-pays (after any deductible is paid) than going to an out-of-network doctor.

I personally prefer a PPO because I see a lot of specialists, and I find it easier to be able to get an appointment without needing a HMO-referral each time I have an appointment. If I need a new doctor (for instance my internist moved out of the area so I needed to find a new internist) I usually ask a doctor I'm already seeing for the names of 3 doctors they would recommend. That way I can look them up with my health insurance's website to see which of them accept my insurance and whether they're in-network.

I don't know the size of your company, but there's no ACA against companies still offering an HMO choice. So you could always give your HR department feedback that you miss having an HMO choice - maybe they'll consider offering that again in the future.
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