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Preferred Provider Organization Your medical plan includes a Preferred Provider Organization (PPO). A select group of hospitals, primary care physicians, specialists, and ancillary providers has been contracted to deliver quality care at a reduced rate. If you seek the services of a PPO provider, your share of the cost of the services you receive may be reduced. The PPO assigned to you is determined by your home address and is specified on your identification card. The PPO is designed to help contain spiraling health care costs through utilization management without sacrificing the quality or the comprehensive nature of your benefits. The PPO physician must follow specific guidelines for utilization of outpatient services whenever possible eliminating unnecessary inpatient hospital stays, and applying the wise use of diagnostic testing and second surgical opinions. You always have the freedom of choice. You may use the services of any covered provider. However, if you choose to go to a physician or hospital outside of the PPO, your deductible, co-insurance, and/or out-of-pocket costs may be greater. Please refer to the Medical Benefit Summary for the PPO and Non-PPO deductible(s), co-insurance level(s), and out-of-pocket amount(s). The PPO Directory you received contains a listing of the Hospitals, Primary Care Physicians, Specialists, and ancillary providers that are contracted with the PPO. Please be aware that sometimes a contracted provider may discontinue participation in the PPO network. It is advisable to check the PPO web site (see the URL on your ID card or PPO directory, if applicable) or contact the PPO by telephone to verify if a provider is currently a PPO contracted provider. Please check your ID card for the PPO that you have been assigned, then click on the appropriate PPO website link below.
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