Many insurance policies today are a Preferred Provider Organization - or PPO. The biggest advantage of this type of insurance is that you, as the consumer, will typically pay a set co-payment amount for a doctor’s visit, regardless of how much the doctor charges for that particular visit, as long as that doctor is a part of the PPO‘s network of professionals. As a rule, the PPO insurance plan will cover any additional costs associated with that visit - including X-rays, blood work or any other tests the doctor orders, as long as the procedure occurs within the doctor’s office.

The same is true of a hospital stay, but it’s important to note that some professional charges - lab technicians, for example - may be billed separately and not be considered part of the hospital co-pay. If the insurance includes drug coverage, a similar policy holds true there, though the co-pays will be different for generic drugs than for brand name drugs.

The advantage to the individual or family is evident. It will cost the same amount - usually $20 or $25 - for every office visit, no matter what. The insurance company has contracted with those health care professionals within its network to provide services at a discounted rate.

If a person insured under a PPO plan choose a health care provider or facility outside the network, the insurance typically pays, but the co-payment is higher.