Average Cost of Rehab with a PPO
Average Cost of Rehab – Using a PPO
A PPO – preferred provider organization or participating provider organization – is a fairly new phenomenon in health care insurance coverage. Basically, it is a managed-care organization made up of health-care providers (including both doctors and hospitals) who have entered into a binding agreement with an insurer to provide reduced-rate care for PPO-insured patients. The “reduced-rate” part is good, but the “managed” part not so much.
The chief drawback of using a PPO to cover rehab costs is that you have to use one of the providers within the network, which limits your range of selections. In some ways, a PPO has fewer restrictions (if, of course, you use one of the providers within the network) than, say, an HMO. It is, in some ways, a trade-off.
So when asked about the average cost of rehab with a PPO, we have to answer: “It depends.”
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Benefits of Using a PPO to Cover the Average Cost of Rehab
There are several benefits to using a PPO to cover the costs of rehab. One of these is that some PPO insurers provide at least adequate coverage for both detoxification and inpatient treatment. You can generally gauge the quality of your PPO coverage by the number of treatment days allowed.
Although there are restrictions on which facilities and health-care providers you can use, this often means they have been screened, and you don’t have to worry about competence and quality of care. This arrangement can also save you time and money because the qualified professionals are easier to locate with PPO-provider listings.
And even if you do opt for a facility or doctor outside the PPO network, a portion of the rehab treatment costs may still be covered. You do have some choices, though your options are more limited than with traditional healthcare insurers.
PPO Tips for Meeting the Average Cost of Rehab
In order to squeeze the most out of your PPO coverage and make sure you get the best treatment for you individual situation, you need to be aware of a few things.
PPO insurers generally do a good job of screening health-care providers before admitting them to the network – but not always. With over 10,000 detox and rehab facilities in this country, you do need to do your research.
Some PPOs will require that you pay a percentage of your treatment costs up front and then reimburse you for a portion of that later. Be sure to check this out so you won’t be caught off guard and stuck with an unexpected bill.
You must be flexible and prepared to adapt. It may turn out that after you’ve found just the right rehab facility for your needs, it isn’t one in the PPO network. But if you’re prepared to shoulder part of the cost burden, you may still find that your treatment choice is partially covered under your PPO.
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Currently, the dizzying array of insurance options can be an extra burden for people already suffering substance-abuse problems. Contact us today for free information about PPO coverage for your treatment.