What Does PPO Stand For In Medical Insurance?
Why You Should Probably Avoid This Plan...
Let’s talk about PPO in medical insurance. If you’re always on the move or living abroad, understanding your medical insurance options is key. PPOs are popular, but they come with pretty big catches in my eyes.
Things like high deductibles and limited networks can be a hassle. I’m here to break it down for you and help you understand what is included in a PPO, why it might not be worth your money, and what other options will be better for you as an international expat.
In this blog, I’ll cover the downsides of PPOs and why they might not suit a global lifestyle. I’ll also compare them to our medical insurance, which is designed to cut out those extra costs and give you freedom to choose where you get care.
This is for the travellers and the entrepreneurs who need clear, straightforward insurance advice. Stick with me, and I’ll help understand exactly what a PPO plan is in medical insurance. No waffle or confusing jargon, just the facts you need.
Let’s get started.
What Does PPO Mean?
Ok so, PPO stands for Preferred Provider Organisation. This is a type of medical insurance plan where you pay a discounted rate if you use the doctors, hospitals, and other healthcare providers that belong to the plan’s network.
Essentially you can select hospitals or doctors within your PPO insurance providers network. Then if you visit these places, you will get a discount on your hospital or medical bills. To be honest, it’s not really a good plan to choose.
Now, you can still use providers outside of the network but this is going to come at a higher cost, more than likely you’ll be forking out the main brunt of your medical bills without your insurance covering much.
Example of how PPO medical insurance works
Let’s say for example, you’re covered under a PPO plan by ‘Nomad Health Coverage’. This plan allows you to visit any healthcare provider within their network at a reduced cost. This could be a doctor in London, UK or a hospital if you need insurance in Thailand.
For instance, if you need to see a cardiologist as part of your out-patient benefits and you choose one that’s in the ‘Nomad Health Coverage’ network, you’ll pay less for your visit compared to seeing a cardiologist outside of the network.
However, if you’re travelling and need to see a doctor in a country where ‘Nomad Health Coverage’ doesn’t have a network, you are going to be pretty screwed.
Even though you need to get medical attention, the insurance will only cover you a little bit because you haven’t chosen their provided network. Not only is it going to increase the cost of your health insurance, but you’ll have to pay a higher share of the bill as well. Doesn’t seem fair to me?
This is why PPO plans are not the most suitable option for those of you who travel frequently or live internationally. The benefits are maximised only when using in-network services which most of the time, are limited to each country.
Why Is PPO Relevant To Medical Insurance?
The reason why PPO is relevant to medical insurance is because it’s a common plan that people get caught up in because it’s got a lot of insurance companies selling it. Think about it, everyone is making a cut.
All the hospitals inside the network make a cut, and the insurance provider that’s selling you the insurance makes a cut as well. This means it’s pushed more because it’s better money for both parties.
But let’s be realistic. This plan is extremely limiting, especially if you are a digital nomad, international expat or overseas traveller. Not only do you pay for your insurance, you also pay a deductible at the hospital and you’re limited to which ones you can choose!?
In all honesty, PPO shouldn’t really be relevant to medical insurance. Definitely when it comes to overseas or expats living abroad. It’s very limiting. I can see that maybe if you are at home or in the USA why this might be popular, but not anywhere else.
What Is a PPO Medical Insurance Provider?
So, the medical insurance providers are the ones called PPO (preferred provider organisation). It basically means they have partnered with specific hospitals or medical facilities to ensure all of their patients will go through them.
When you’re part of a PPO, you’ll typically receive a list of in-network providers, and you’re encouraged to use these for your healthcare needs to take advantage of the lower rates. To be honest, I’m not sure how fair this is because it really restricts you in case of emergencies and limits the expensive stuff like your in-patient benefits.
These insurance providers are limited to cover you only at specific places within their lists of networks. If you go outside of their network, they will charge you more and force you to pay for the bulk of your medical costs.
I would not recommend going with a PPO medical insurance provider, the downsides are just too much. It doesn’t make logical sense. I mean, the fact you have to still pay a deductible doesn’t make sense.
In my eyes, the insurance provider isn’t doing their job by not covering you in all areas. Not only that, by making you pay a deductible as well as pay them insurance fees sounds too unfair to me.
You Can Only Choose Hospitals Within Your PPO Providers Network
As I mentioned above, you can only choose hospitals within your medical insurance providers network. Well, what happens if you are travelling abroad? What happens if you are on a day trip?
What happens if you have an emergency and the closest hospital is one your provider does not cover? Then you’re going to be left with a nasty shock bill. All whilst you’ve paid for your insurance upfront as well.
Now, while it’s not entirely accurate to say you can only choose hospitals within your PPO provider’s network, it is true that you’ll get the most financial benefit from staying within the network. If you do find yourself out of the network, prepare yourself to pay a big bill.
While this might work for people who don’t ever move around and stay or live close to a hospital within their network, it doesn’t suit nomads or international expats. Think about it, how are you going to find a good PPO that covers all the hospitals you need globally?
That doesn’t really exist. If you do choose a PPO, just know that you are limiting yourself and probably wasting your money on that insurance given your circumstances.
You Still Have To Pay Out Of Pocket Costs With PPO
Yep. Yet another big downside to PPO insurance plans. Even with their so-called ‘benefits’ you’re not exempt from out-of-pocket costs. This literally makes no sense because you’re paying for their insurance but still having to fork out of pocket costs.
Realistically, like our insurance, you shouldn’t be paying any deductibles of out of pocket costs. Good providers will remove the excess you have to pay and make sure your experience is stress free.
This is the difference between PPO plans and medical insurance like us, with PPO you’ll be paying low deductibles, with nomad medical insurance you don’t have any out of pocket costs and all bills are paid directly to the hospitals.
Now, I’ll go into more details about this later but PPO actually costs more than medical insurance as well… I know!? How does that even work? Let’s go through it shortly.
It’s Probably Not The Best Plan To Choose As an International Expat
Now, for international expats the limitations of a PPO plan’s network is going to be super annoying for you. Like I briefly covered above, you are limited wherever you go, worldwide. Not only this, but PPO most likely try and only cover the country.
The network is typically based on a specific geographic area, which may not be practical for those who travel frequently or live abroad. As an expat, you require a medical insurance plan that provides comprehensive coverage across various countries and continents, without the constraints of a network.
This is something you are going to get with fully comprehensive medical insurance instead. Additionally, accessing healthcare in a foreign country can be complicated, and relying on a PPO network may limit your options and result in higher costs if you need to seek care outside of that network.
Then you’re just paying double, once to the insurance and next to the hospital. You may as well have just saved the money and chosen a good medical insurance plan.
It’s Going To Be More Expensive Than Normal Medical Insurance
Believe it or not. You would assume due to all the limitations that PPO insurance would actually be quite affordable. Nope, it’s more expensive than even major medical insurance. That’s quite shocking considering what they both provide.
I suppose the reason why they are more expensive is because they claim to be flexible providing multiple hospital options. Which is exactly not what they are, because flexible would mean covering all hospitals.
Anyway, like I’ve said a few times now, I’d recommend avoiding PPO medical insurance because it won’t give you the coverage you need as an expat or wanting medical insurance whilst living abroad.
Don’t forget, you also have to pay out of pocket costs with these whereas medical insurance you do not. Yet another added cost that makes PPO insurance more expensive as well.
The only way I can see this worthwhile is if you are living in a country and need to frequently visit your hospital of choice where the doctors know you well. Maybe that’s the only time I would choose PPO insurance, but as a nomad I’d pass on that one.
Conclusion
Well, I think we can all agree that PPO insurance plans might be a waste of your money. Not only do they cost more than medical insurance, they actually cover you for less as well because you are limited to healthcare providers within their network.
For those living a global lifestyle, it’s often more practical to consider medical insurance options that provide comprehensive international coverage without the constraints of a network.
As I always say, your health is your wealth, especially when you’re far from home. Don’t go wasting your money on PPO insurance plans that don’t suit your requirements. If you need any advice, you know how to contact me.
Please feel free to share your thoughts in the comments below!
