Saltar al contenido principal

Asistencia lingüística

English
 

¿Qué es una cobertura PPO?

 

Why PPO is a Good Choice

If you like having the flexibility to choose the doctors, hospitals and other health care providers you use to get care, and you can afford to pay more, PPO insurance may be the right plan for you and your family.

PPO plans let you choose where you go for care, without needing a referral from a primary care provider (PCP). They typically have higher monthly premiums than HMO plans. At times, a PPO plan has a larger and broader network of providers.

Una cobertura PPO puede ser una buena opción para usted por estos motivos:

  • No necesita un médico de cabecera para que coordine su atención médica.
  • No necesita un referido para acudir a un especialista.
  • You want a broader network of doctors and facilities.

Often, you can get care from in-network or out-of-network providers but pay more for out-of-network care. However, some PPO plans do not cover care from out-of-network doctors or hospitals so be sure to check your benefits.

Finding Providers in the PPO Network

To make sure a provider is in your plan's network, learn about our Atención médica tool. This tool allows you to find the doctors, hospitals and other providers covered by your plan.

Si es un asegurado de BCBSIL, inscríbase o ingrese a  Blue Access for MembersSM, nuestro sitio protegido para asegurados, para realizar una búsqueda personalizada en base a su seguro de gastos médicos y red.

Cómo usar su cobertura PPO

  • Before you go. You may need to get prior authorization (or pre-approval) from BCBSIL before getting certain tests or services. Desde el consultorio del médico llamarán al número que aparece en su tarjeta de asegurado de BCBSIL para confirmar. You can also call before you go for care to confirm authorization.
  • For non-emergencies.  For a common illness or injury, like a cold, flu, minor cut or burn, you have a few  options to get care. Learn where to go.
  • Ante una emergencia. When your injury or illness is serious or life-threatening, call 911 or go to the nearest emergency room. You won't have to pay out-of-network costs if it is an emergency. Not sure what’s an emergency? Más información.
  • For specialists, behavioral health or hospital care.  You do not need a referral to see a specialist or behavioral health care provider. 

Lecturas sugeridas

Ingresar a Connect