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Question:

What does it mean that being in the PPO network will cover "negotiated fees on services only"? Is emergency hospitalization and surgery covered? Are emergency labs covered? What in the health care coverage is not a "service"?

Answer:

The plans will cover the new illnesses and injuries that manifest after their effective date. They exclude coverage for pre-existing conditions, preventative and routine care. Plans will PPO networks have network negotiated rates that are between the provider (medical professional) and the network. The rates are negotiated for the services the medical professional provides. Plans with PPO networks do not restrict you from going outside of the network, but it is important to note that depending on the plan the coverage may be different, such as a different coinsurance that is used out of network. Should you have additional questions or need further assistance please let us know. You may also call our office at (866) 467-8289.

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DISCLAIMER: Information presented in our Questions and Answers section is generic and was deemed to be accurate at the time of response. Please use the answers as a guide and do not make decisions based on the answers. The answers presented may be outdated and altogether inaccurate currently or not relevant as the details provided such as the insurance terms and conditions, plan benefits, eligibility and coverage may have changed. Insubuy assumes no responsibility for relying on such answers. You should review the latest certificate wording of the insurance policy (available on this website) for the product you are considering for the latest and complete details. If there is any conflict between the answers provided here and the certificate wording, the details of the certificate wording will prevail.

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