With the PPO option, participating providers agree to accept United Health Care's determination of reasonable allowable charges as payment in full. If you choose the PPO you may receive treatment in or outside of the network. However, if you receive treatment by a provider outside the network, United Health Care will only reimburse that provider a certain percent indicated in the summary plan description, and then only for reasonable and customary charges. The out-of-network provider may bill you for the balance due on the account after United Health Care has made payment for the service.
Factors to Consider:
- Large selection of network providers in the United Health Choicecare PPO Network.
- The university pays a percentage of the covered cost as outlined in the summary plan description after you meet your annual deductible.
- The university pays a lower percentage of the covered cost when you use a provider who is out of the network.
- Your monthly contribution is lower but possible out-of –pocket costs higher when you select a PPO plan.
For a detailed list, consult your Summary of Benefits (PDF).