How to Participate in a Health Care PPO

A health care PPO insurance plan is a great option for employees who don't want to go through the red tape of getting every physician they see approved by their HMO primary care provider. With a PPO, you can make appointments with your in-network dermatologist, allergist or other specialist without prior approval. Here's how to participate in a health care PPO.

Instructions

• 1

  Read your Explanation of Benefits before using your PPO insurance. This way you won't be getting any unwelcome surprises from medical billing departments. The most important things to look for are co-pay costs, deductibles, limits on coverages and allowances for different types of medical services.

• 2

  Check the health care PPO's network to see whether the doctors you want to see are on the plan. Most PPOs list their in-network providers in an online directory or publish a guide organized by region and specialty. If you can't find this information, call the customer service number listed on your card to see whether your health care providers are considered in-network.

• 3

  Find out whether any of your medical bills will be covered if the doctor is not in-network. Some PPOs will cover a smaller portion of the bill, while others won't offer any coverage at all.

• 4

  Present your insurance card at your first office visit or medical service. You should be asked to pay the co-pay only (unless there's a deductible).

• 5

  Check your Explanation of Benefits or call customer service if you're anticipating any expensive medical treatments, like surgery or childbirth. This way you'll know what to expect when the bill arrives.