asked 134k views
4 votes
Coverage for care received from a network provider pays more than care received from a non-network provider in what type of health plan?

Hospital indemnity
Self-insured plan
Preferred Provider Organization (PPO)
Health Maintenance Organization (HMO)

asked
User Abed
by
8.3k points

1 Answer

0 votes

Final answer:

In a Preferred Provider Organization (PPO) health plan, a higher coverage amount is paid for services from network providers compared to non-network providers, offering better rates since the insurance covers a greater portion of the costs.

Step-by-step explanation:

Coverage for care received from a network provider pays more than care received from a non-network provider in a Preferred Provider Organization (PPO) health plan. This type of plan has a network of providers that offer services to members at a lower cost compared to non-network providers. Going to a provider within the PPO network often means that the insurance will cover a higher percentage of the cost, thus reducing out-of-pocket expenses for the insured individual. Members can still choose to see providers outside the network but will typically face higher costs as a result.

In contrast, an Health Maintenance Organization (HMO) provides care from within its own network of health care providers and generally does not cover services by those outside the network except in special circumstances. A Hospital Indemnity insurance pays a set amount per day of a hospital stay regardless of the actual costs incurred. Self-insured plans are employer-provided plans where the employer assumes the financial risk for providing health care benefits to employees.

answered
User Irongirl
by
7.6k points