Colonial Health Insurance PPO: Benefits, Coverage and FAQs

Introduction

Colonial Health Insurance PPO is a type of healthcare insurance offered by Colonial Life & Accident Insurance Company. The coverage is available in select states across the United States of America, including Alabama, Arizona, Colorado, Florida, Georgia, Illinois, Indiana, Kansas, Kentucky, Louisiana, Maryland, Missouri, Nebraska, North Carolina, Ohio, Oklahoma, South Carolina, Tennessee, Texas, Virginia, West Virginia, and Wisconsin. This article focuses on the benefits and coverage provided by Colonial Health Insurance PPO and answers frequently asked questions about the insurance policy.

Benefits and Coverage

Colonial Health Insurance PPO provides coverage for a range of medical services and treatments, including:

The insurance policy also covers preventive care such as annual check-ups, flu shots, and mammograms, which are covered at 100%. The policyholder can choose a primary care physician and specialist within the PPO network. Out-of-network providers are also covered, but the coverage is limited.

Premiums and Deductibles

The premiums and deductibles for Colonial Health Insurance PPO vary depending on the state, age, and health condition of the policyholder. The policyholder can choose from different deductibles, which is the amount the policyholder is responsible to pay before the insurance coverage kicks in. The higher the deductible, the lower the premium. The policyholder can also choose from different coinsurance options, which is the percentage of the cost of covered medical services that the policyholder is responsible to pay after the deductible is met.

Enrollment and Renewal

The enrollment period for Colonial Health Insurance PPO is generally open during the fall months, with coverage starting in January of the following year. The policyholder can enroll online, by phone, or through a licensed agent. The policy can be renewed annually, with changes to the premium and deductible based on the policyholder’s health condition and age.

FAQs

Q: What is a PPO?

A: PPO stands for Preferred Provider Organization. It is a type of healthcare network that allows policyholders to choose from a group of healthcare providers that have contracted with the insurance company to offer healthcare services at a lower cost. PPO networks provide more flexibility to the policyholder than HMO networks, which require the policyholder to choose a primary care physician within the network and require referrals to see specialists.

Q: How does a PPO work?

A: When a policyholder chooses a healthcare provider within the PPO network, the provider charges a contracted rate that is lower than the rate charged to patients outside the network. The policyholder is responsible for paying a deductible, coinsurance, and copayments for covered medical services. If the policyholder chooses an out-of-network provider, the coverage is lower and the policyholder may have to pay more out-of-pocket costs.

Q: Are preventive care services covered by Colonial Health Insurance PPO?

A: Yes, preventive care services such as annual check-ups, flu shots, and mammograms are covered at 100% by the insurance policy.

Q: How can I find a healthcare provider within the PPO network?

A: Colonial Health Insurance PPO provides a directory of healthcare providers within the network. The policyholder can also call the customer service number on the back of the insurance card to find a provider.

Q: Can I change my deductible and coinsurance options?

A: Yes, the policyholder can change the deductible and coinsurance options during the open enrollment period or at other times during the year with a qualifying event such as a job loss or a change in family status.

Q: Is dental and vision care covered by Colonial Health Insurance PPO?

A: No, dental and vision care are not covered by the insurance policy. The policyholder may need to purchase a separate dental and vision insurance policy or pay out-of-pocket costs for these services.

Conclusion

Colonial Health Insurance PPO provides coverage for a range of medical services and treatments at a lower cost for policyholders who choose healthcare providers within the PPO network. The policyholder can choose from a range of deductibles and coinsurance options to customize the premium and coverage. Preventive care services are covered at 100%. The policy can be renewed annually, with changes to the premium and deductible based on the policyholder’s health condition and age. However, dental and vision care are not covered by the insurance policy, and the policyholder may need to purchase a separate insurance policy or pay out-of-pocket costs for these services.