PPO vs Point of Service Plan

So, in both a PPO plan and a Point of Service plan, you can go in-network for your care. Or if you want to pay more in deductible and out-of-pocket costs, you may choose to go out of network and there will be coverage for it. So, employers always say, okay, so what’s the difference between a PPO and a Point of Service plan? Both those plans do that.

So, if you look at what a point of service plan is, it’s written on HMO paper. So, it’s an HMO plan with an ability to go out of network. So, every, all of the contracts for the providers are still based on that HMO plan in network. A PPO plan is not an HMO plan. It’s based on insured paper.

So, this is different kind of paper that gets filed with the state for regulatory purposes. A PPO plan is a regular insurance plan that has an in-network and an out-of-network benefit. It is not written on what we call HMO paper.

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