When you choose a PPO plan, you can receive care from any licensed physician you want. If you use a network physician, you pay less out of pocket, you don’t have to file claims, and you get the highest level of benefits. If you use a physician outside of the network, you are still covered, but your out-of-pocket costs will be higher. With a PPO, you always have the freedom to choose between in-network and out-of-network care. Referrals are not necessary.
The traditional major medical benefit options give you the freedom to choose any licensed physician or hospital for treatment. However, if you use non-contracting providers, your out-of-pocket costs will be higher because you may be responsible for charges over the allowable amount. Traditional medical benefit options give you access to any licensed physician or hospital–-including specialists–-for covered expenses, with no need for a referral. With traditional medical benefit options, the choice is always yours.
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