Blue Shield PPO plans offer more fleibility in choosing health care providers albeit at a higher cost. You have the option to use in-network or out-of-network services and consult with any licensed doctor you wish to see. However, with Blue Shield PPO, your deductibles and out-of-pocket epenses are higher as compared with your current HMO insurance plan especially when you use out-of-network health care services. For eample, if you decide to use in-network services, your health insurance plan will pay about 80% of most of the covered costs as indicated in the policy. A doctor’s visit may cost around $20 depending on the type of health insurance plan you choose. This out-of-pocket payment is separate from a yearly deductible which is usually higher than those with HMO insurance plans. Another benefit of this plan is that Blue Shield PPO will file the claim for you, thus saving you the trouble of endless paperwork that you usually eperience in your HMO plan. If you choose an out-of-network provider in a PPO plan, your deductible is higher compared with that of in-network provider plans. Your policy will pay 60% of the covered epenses based on the allowed amount indicated in the plan. Also, you must file the claim with the insurance carrier before you can reimburse the out-of-network rates. Another benefit you have with Blue Shield PPO is that you can use your prescription drug benefits through Blue Shield’s in-network pharmacies. - June 26, 2009 @ 3:14pm