Preferred provider organization
405
MENTIONS
165
EPISODES
136
PODCASTS
Search complete. 405 mentions across 165 episodes found for "Preferred provider organization".
Oct 26, 2026
Mark ChayetteHOST
Oh, yeah.
Larry JonesHOST
According to the Department of Insurance in the state of Michigan, the insurer – are you ready for this, Dr. Mark? Blue Cross controls 65% of the HMO insurance market in Michigan and 79% of the PPO market.
Mark ChayetteHOST
Wow.
Mark ChayetteHOST
In the whole state of Michigan? In the whole state of Michigan.
Mark ChayetteHOST
I mean, that's really 65%? 65 HMO,
Larry JonesHOST
79
Mark ChayetteHOST
PPO.
Mark ChayetteHOST
Man.
speaker_0HOST
I want to establish a dictionary right off the bat, translating these dense terms into physical analogies for you.
speaker_0HOST
So let's start with the word network because you see HMO and PPO on literally every single piece of mail.
speaker_0HOST
In the real world, outside of insurance, what is a network?
speaker_1GUEST
Well, the most accurate way to visualize a network is to think of a country club.
speaker_1GUEST
Right.
speaker_1GUEST
The club pays absolutely nothing.
speaker_1GUEST
Now, a PPO, a preferred provider organization, operates a bit differently.
speaker_1GUEST
It's a country club that acknowledges you might want to eat elsewhere sometimes.
Ed WeirHOST
So that's why a lot of people, that's why they have to have a PPO plan.
Ed WeirHOST
And so people that live outside the big cities are getting a really big crunch because they're losing their PPOs and Medicaid is losing a trillion dollars throughout the country.
Ed WeirHOST
And hospitals depend on Medicaid to, you know, to stay open.
Ed WeirHOST
And when those hospitals don't get paid for helping people out, then they're going to start closing doors.
Keith WallaceGUEST
And what they're doing is that they're reducing the amount of plans available so that they can drive the risk to the plans that they have better chances of navigating.
Keith WallaceGUEST
So, for instance, you used to be able to buy what's called a PPO plan, a preferred provider organization plan, to where you could pick any doctor that was at Family Care Network and go see them.
Keith WallaceGUEST
So you go see a specialist without a referral.
Keith WallaceGUEST
The plans that are left are HMO plans, health maintenance organizations.
Haley SchultzHOST
But it is also smaller regional groups, as I said, and those aren't necessarily all targeting Medicaid patients.
Haley SchultzHOST
Many are more targeting PPO insurances.
Haley SchultzHOST
So some potential advantages with the DSO systems is just that, that they are systems, they are focused on turning a profit.
Haley SchultzHOST
So they absolutely are going to try to have these offices run as efficiently as possible.
Cynthia HillGUEST
Amazing.
Cynthia HillGUEST
Nine times out of ten, your doctor's going to be in one of those networks, right? There's also PPOs, which means Preferred Provider Organization.
Cynthia HillGUEST
Those plans will allow you to go to out-of-network doctors, but it's going to be at a higher cost share for you.
Cynthia HillGUEST
So let's say that your primary care is in network.
Jay CampbellGUEST
And as I like to think there's no coincidence is only synchronicities in the universe.
Jay CampbellGUEST
I went to my PPO, which was my, you know, HMO.
Jay CampbellGUEST
I mean, not my HMO, but my, um, insurance doctors through my benefits with the LA times, um, And he was a super cool brother and he recommended me to a world renowned, of course, I didn't know at the time, endocrinologist named Dr. Raymond Scruggs.
Jay CampbellGUEST
He was Harvard trained and he took my labs and he's like, look, did you got the testosterone levels of an 85 year old geriatric man? I can put you on therapeutic testosterone and within eight weeks, you'll be right as rain.
Maya Marshall-HoffGUEST
But that is happening because of the result of the cancellation of both Wellmark and Medicare Advantage preferred services.
Maya Marshall-HoffGUEST
provider organization coverage or PPOs.
Maya Marshall-HoffGUEST
That means there's a little bit more flexibility and coverage.
Maya Marshall-HoffGUEST
But those providers offer plans to a lot of folks.
Maya Marshall-HoffGUEST
So that might change how they're able to get care with the Mayo Clinic if they're on these plans.
Maya Marshall-HoffGUEST
And they might have to find a different coverage plan that might... serve the same purpose, but for Walmart and Medicare, they're canceling their preferred provider organization coverage through Medicare.
Ben KiefferHOST
I understand that Wellmark and Medica are both ending Medicare Advantage PPOs.
Ben KiefferHOST
Translate that for us.
Melissa MooreHOST
And it really is about protecting corporate profits is what the story I was reading said.
Melissa MooreHOST
And most of these plans, by the way, are PPO plans.
speaker_0NARRATOR
Well, trick down electric bike.
speaker_0NARRATOR
We've seen them.
Ed WeirHOST
No, it's not dead.
Ed WeirHOST
My Advantage Giveback PPO plan just went from $95 down to $55.
Ed WeirHOST
My dental plan went from $1,500 down to $750.
Ed WeirHOST
It is what it is, I
155 more episodes mention Preferred provider organization.
Create an account to see the whole feed, search across every transcript, and follow the entities you care about.