PPO Network - Frequently Asked Questions

What is a PPO Network?

Our medical benefits are provided through a Preferred Provider Organization (PPO) plan. A PPO plan means that the ICSVEBA contracts with a network of participating physicians, specialists, healthcare facilities, and other healthcare providers to provide our health plan participants with lower health costs. The contracted providers agree to charge our health plan participants based on a lowered fee schedule for the healthcare that is provided to the member. Therefore the cost for the healthcare service is at a cost lower than what the contracted provider would charge to a patient treated outside the network.

What is the Difference Between an In-Network and Out-of-Network Provider?

In addition, the medical plans are designed with an incentive for the health plan participant to receive healthcare from a PPO provider, also called an in-network provider. The plan pays a significantly higher co-insurance (a portion of the service that the plan is responsible for paying in the form of a percentage after the annual deductible is met) when the member receives healthcare from an in-network provider. If the healthcare service accessed is not subject to a deductible, such as an office visit, a nominal co-pay is charged when the member sees an in-network provider. For this same office visit service, the annual deductible and a much lower co-insurance applies when the member sees an out-of-network provider.

Is My Provider in the Network?

The ICSVEBA has contracted with Blue Cross (Prudent Buyer Plan) for the PPO network. Save yourself the expense, and ensure your healthcare providers are in-network!