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When you are looking for health insurance plans, you may come across a policy that states it is a Multiplan PPO. This sounds a little confusing because the name implies that it is a health insurance plan that is made up of multiple different plans. But that is not the case.
What Are The Two Major Parts To The Network?
Each service provider network covered under these plans can be divided into two networks:
Multiplan Network. This plan broadens the network of services and providers offered under a standard PPO policy. These plans offer the most choices to consumers and are considered to offer the most value.
PHCS Network. PHCS, or Private Health Care Service, is a private PPO that offers members the ability to use providers or services across the country that are within their network.
What Is Multiplan PPO?
A Multiplan PPO is a health insurance policy that is part of a large network of service providers and facilities across the country that have agreed to offer services at a discounted price for policy members.
Established in 1980, Multiplan is the oldest PPO network in the United States. As of 2020, there are over 4,500 hospitals and 550,000 medical care providers that participate in the Multiplan network.
Multiplan is not a health insurance provider. It is an add-on service for current health insurance plans that broadens their network of providers and helps reduce the overall cost of services. You can find PPO, HMO, and even some self-insured plans that offer the Multiplan service as part of their insurance program.
Benefits of Multiplan Compared to Other Companies
The largest benefit of Multiplan over other companies is the vast network of providers and services available under the plan. Over a half-million health care providers participate in this plan, and over 4,500 hospitals accept Multiplan. With so many providers available, consumers can get the services they need from the provider of their choice at an affordable rate.
The second-largest benefit of using Multiplan is affordability. Multiplan providers have agreed to a price that is considerably lower than what many people pay using other forms of insurance. Multiplan is able to offer such reduced prices because of the size of its network of providers and plan holders.
Why Is Multiplan So Important?
When the Affordable Care Act was first implemented, insurers were not really prepared. The addition of so many new clients and the broad range of their services ended up creating chaos for at least the first year of the program.
Over time, the insurers have begun to streamline the insurance products that they are offering on the healthcare marketplace and selling directly. Some insurers have even dropped healthcare policies altogether. With so many policies being canceled and eliminated, the choices for the consumer have dramatically decreased.
Consumers are finding it harder to find policies that meet their needs in terms of preferred health care providers of facilities. Some consumers are finding themselves paying for insurance and then having to pay out of network fees for using the services they need.
Using a Multiplan PPO can help eliminate that frustration and overspending on health insurance premiums and expenses. The large range of providers and health facilities included in these networks makes it more affordable for consumers to use the insurance when they see the care providers that they prefer.
Enjoying the Flexibility of a PPO
When we work with our clients to find the best health insurance quotes, we are often asked what the differences between an HMO and a PPO are and which one is preferred by most of our clients.
An HMO is a Health Maintenance Organization. HMO’s will generally have an exclusive set of medical care and service providers that they use as part of their plan. Clients who have the HMO will be required to establish a primary care physician through whom all of their medical care is directed.
At any time that the patient feels that they need medical care or specialty care, they will have to go to their primary care physician and get a referral for the services. The referral will be to a service provider within the network. Of course, if you need emergency medical care, you would just go to the emergency room.
Needing to get a referral for a specialist, testing, imaging, or other services can prolong the time necessary to receive medical care. You will first have to wait for an appointment with your primary care physician and then wait for an appointment with the specialist. Many people do not like this part of the HMO set up.
Depending on the size of the HMO, the network of available doctors and hospitals may be limited. It is important to understand that having insurance does not necessarily mean that the hospital or medical care provider of your choice actually accepts that insurance.
HMO policies may also have very high out of network costs. If you have to get treatment outside of your network, you may be held 100 percent accountable for all of the related costs when you have an HMO policy.
A PPO, or Preferred Provider Organization, is a much broader type of coverage. A PPO will have a large network of medical care and service providers that the insured can use. In many cases, it will also have lower copayments for services compared to an HMO because there is such a large range of providers available, which makes lowering the process possible.
People who are insured with a PPO do not have to establish a primary care physician to receive medical or specialty care. If you want to see a specialist, all you do is find one within the network and schedule an appointment—no waiting or delaying your care. You will also enjoy being able to seek out more medical care options while traveling in the United States because PPO programs often cover multiple states in their coverage areas.
Most clients like the flexibility of the PPO over an HMO insurance plan. However, A HMO is also a very valuable plan and may serve some people better than a PPO. For the best answer to this question, it is important to make a side-by-side comparison of the available insurance plans in your area to see which one will give you the most benefits for your investment.
Get Your Multiplan Health Quotes Today!
You do not have to wait for open enrollment to open on November 1st to start gathering quotes for health insurance. You can start getting quotes on different health insurance products today.
Affordable Health Plans USA can help you find out all of the important information about health plans in your area. You can look over the differences in available HMO and PPO plans, as well as the different levels of each.
Under the Affordable Care Act, health insurance plans, regardless if they are HMO or PPO, are classified as Bronze, Silver, Gold, or Platinum level plans. Each of these levels is used to denote the amount of coverage, cost, and overall service you will receive from plans within the category.
Bronze level health insurance plans are generally the least expensive plans, but they carry very high yearly deductibles and copayments. These plans may also have a limited network of providers.
Silver level health insurance plans are a little better than Bronze plans in terms of copayment, but they generally still have higher yearly deductibles and small networks of providers. These plans may include discounted wellness services as part of their program.
Gold level helath insurance plans are very good plans that have lower yearly deductibles and copayments than the other plan. These plans have larger networks of providers and may include free wellness programs as part of the insurance policy. You will see more PPO plans at the Gold level or higher than at the lower two levels.
Platinum level health insurance plans are the best plans available. They have the highest premiums but the lowest deductibles and lowest copayments. Platinum plans will also have the largest networks of providers and will offer other benefits to their clients.
You should not have to rush through selecting the right health insurance plan. It will always be beneficial to make an informed decision so that you are never surprised by denial for service or large medical bills after you purchase a policy.
It is our goal to help you find the right health insurance policy by giving you a detailed analysis of the available plans in your area so that you can make a comparison of what is being offered and what the cost for the services will actually be for each plan.
Where Are Multiplan Plans Available To Purchase?
You can purchase a Multiplan policy directly from an insurance provider or on the healthcare marketplace. Many of the Multiplan policies available on the marketplace are in the gold and platinum categories. However, there are plans that may be available at the silver and bronze level in your state. Each state offers different plans in the marketplace.
If you are interested in a Multiplan policy, it will be in your best interest to shop around for these plans to find the best price. Affordable Health Plans USA can give you side-by-side comparisons of available plans so that you can find the best price structure to meet your needs.
The average Multiplan prices are often better priced purchasing directly from the insurer. While many people look to the marketplace for better deals, you may be very surprised by the discounts that you can find purchasing directly with this type of plan.