If you use health insurance, then you may have heard a few people talk about Multiplan and the services they render. There is a common misconception that Multiplan is an insurance company and that you can buy insurance from them? The reality is that they are not an insurance company but a Preferred Provider Organization (PPO).
When you enroll under any health insurance plan, your insurance company will provide you with a list of doctors, hospitals, and specialists in contract with them. They are referred to as in-network doctors, hospitals, specialists, and what have you.
Through Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs), these medical practitioners and facilities are made available to you.
On this note, we can conclude that while PPOs like Multiplan do not offer traditional health insurance services, they are a crucial part of the process.
Steps To Select A Provider Using Multiplan
By this point, you are well aware that Multiplan is not an insurance provider. Rather they are a Preferred Provider Organization (PPO).
It is their job to connect you with excellent medical services via the help of your provider. You
Identify Your Needs
The first step to choosing this situation is identifying your needs in terms of health and a preferred provider.
It is no surprise that most individuals have a particular doctor they visit, like how most families have a specific doctor who handles all health matters relating to that family. Our advice is to ensure that your doctor is a part of your PPO network.
Frequent visits to doctors out of your network will become expensive over time. You can enquire if your doctor is a part of your network from the doctor or your health insurance provider.
Some services are more relevant to us than others when it comes to healthcare. We should keep in mind those services that are relevant to us when selecting a PPO; this is because different PPOs have varying coverages for certain services.
You can always consult your doctor to know what ailments you are at risk of and need coverage for.
Research On Different PPO Providers
You can’t expect all providers to give you the same service quality; while all of them may be good, it doesn’t mean they will be suitable for you and your health needs.
While multiple providers will offer the same insurance plan, they may not offer the same level of coverage. For example, auto insurance in one company may cover theft of private properties in your vehicle, and another company may require a separate policy for this.
Compare Costs
Most people only think of premiums when comparing the cost of purchasing insurance. However, you should also consider computing insurance costs, copays, coinsurance, and deductibles.
However, the most important thing to consider when considering insurance costs is how often you visit the doctor. It would be wiser for someone who hardly visits the doctor to go for a plan with lower premiums.
Suppose you have a chronic disease that keeps you in and out of the hospital, then higher premium plans are better. Usually, such plans have lower deductibles and copays, so you get to enjoy your insurance benefits faster.
Ask Questions
We mentioned this earlier under researching different providers, but it is worth mentioning again. Don’t hesitate to find out exactly what a provider’s plan covers. This puts you in a better position to decide whether the plan is good for you or not.
Pros And Cons Of Multiplan
Pros
Flexibility – PPOs like Multiplan offer more flexibility to individuals because they can seek medical assistance within their network and outside of it. For instance, in Multiplan, you are not required to select a Primary Care Physician.
You also don’t need a referral from your doctor to visit a specialist. However, we think it is a good idea to select a Primary Care Physician so you can enjoy the benefit from wellness programs coordinated by your insurer.
Variety of Services – PPOs have another advantage over HMOs because they have a wider spectrum of services. HMOs coverage is limited to basic services, but PPOs take a step further to cover for items such as treatment from specialists, surgery, and emergency care.
Some PPOs also provide coverage for non-conventional medical practices such as acupuncture, naturopathy, and chiropractor services.
Cons
High Cost – Usually, PPO plans cost more than HMO plans. When looking at the full picture, we cannot entirely rule this out as a disadvantage since you are receiving more benefits for the amount you are paying.
Difficult Claim Process – Everything is a breeze when visiting doctors within your PPO network. The doctors will file all necessary paperwork concerning your insurance provider’s insurance. However, things get tricky with out-of-network doctors.
Suppose you visited a doctor out of your provider network, the responsibility of providing everything your insurer needs to process your claim falls on you. This can be a stressful task to accomplish at times.
| Pros | Cons |
| Wide variety of services | High cost |
| Flexibility | Difficult claim process |
Frequently Asked Questions
What Is The Difference Between An HMO And A PPO?
The major difference between these two services is their network size, choice of specialist, costs, and out-of-network coverage.
PPOs have fewer limitations than HMOs. With HMOs, your coverage is limited to doctors in your network, and there is not much freedom to visit out-of-network providers. There is also a general restriction on your visits even when covered.
Are All PPOs Multiplan?
No, they are not. Multiplan is the largest and most extensive PPO in America; however, it isn’t the only one. Other popular PPOs in America include:
1. Capital Health Screening Center
2. Rumah Sakit
3. Paul Hartmann
4. Vivere Health
How Much Does Multiplan PPO Cost?
Multiplan is not a health insurance provider; hence they do not sell insurance.
Conclusions
Multiplan is not an insurance company but rather a Preferred Provider Organization (PPO) network. Therefore, you cannot buy their services directly with major health insurance providers. However, you can enjoy their services through your providers such as Medicare and Medicaid.
Sources
