Regional PPO plans

A regional PPO has a contract inside its service area. In-network, you generally owe the deductible, copay, and coinsurance on the explanation of benefits, not the hospital’s full list price. Out-of-network, the plan pays an allowed amount and the hospital may bill the rest.

Match the facility on the bill to the network directory for the date of service, not today’s directory. Then compare each patient-responsibility line on the explanation of benefits with the amount the hospital is asking you to pay. Pay the hospital’s larger number only after that comparison.

A regional card does not make a hospital in another state in-network. If you were traveling, read national PPO plans and the balance-bill check.