| An office visit co-pay can be a bit misleading. | | | | deductible. |
| They are different depending on the type of | | | | If a physician charges $120 for an office visit that |
| health insurance plan you are on. A PPO co-pay | | | | means you will be charged $120 just to make the |
| works differently than an HMO co-pay. Most | | | | appointment. If you have an office visit co-pay, |
| California health insurance companies offer PPO's | | | | the $120 charge will be knocked down to |
| with office visit co-pays, while some companies | | | | whatever the co-pay benefit amount is. |
| do not even offer HMO plans at all. | | | | So why choose a PPO style plan? A couple |
| So, what is the difference? Take a Blue Cross of | | | | reasons; first of all the monthly premium will most |
| California HMO plan with a $20 office visit co-pay. | | | | likely be much less. PPO plans offer freedom of |
| Generally when you go to a physician or | | | | choice with physicians, specialists and hospitals. If |
| specialists office, whatever is performed in the | | | | you see a provider within the specified network |
| office the physician charges will be covered by | | | | your costs and coverage will improve. Anthem |
| the plan co-pay, including if you are sent for lab | | | | Blue Cross of California and Blue Shield of |
| work or an X-ray. When you go on an | | | | California for example, have close to 50,000 |
| appointment whether it is for the flu, an annual | | | | providers in their PPO networks. |
| check up, or you sprained your knee hiking. You | | | | Look at the 'freedom of choice' benefit for a |
| can be certain your costs will not be much higher | | | | moment. If I, my wife, or one of my children has |
| than the co-pay itself. | | | | an accident or major illness, the last thing I want |
| Now, for the PPO co-pay. For example, your plan | | | | is to be locked into a small physician network. If I |
| has a $1,500 annual deductible with a $30 office | | | | want to go to Stanford Hospital or UCLA Medical |
| visit co-pay. When you visit the doctors office, as | | | | Clinic, or to a specialist who I think can treat our |
| a rule of thumb, you will pay everything towards | | | | condition the best; I make an appointment, and |
| your deductible except for the opportunity to | | | | go. That is it. It is up to me! I do not have to deal |
| meet with the doctor. If you need an | | | | with a referral or if my primary physician or the |
| immunization, or a blood test, or even an X-ray, | | | | medical group allows me to go outside of the |
| these costs will most likely be out of pocket | | | | predetermined medical group for care. |
| expenses which you will pay towards your | | | | |