Reference no: EM133553497

Case Study: assess knowledgeable of the different terminology used in insurance. Expound on how PPO healthcare plan works in partnership with medical providers to offer reduced prices for medical services to plan members.

Read the discussion question:

Max, age 28, is insured under an individual medical expense policy that is part of a preferred provider organization (PPO) network. The policy has a calendar-year deductible of $1,000, 75/25 percent coinsurance, and an annual out-of-pocket limit of $2,000. Max recently had outpatient arthroscopic surgery on his knee, from a skiing accident. The surgery was performed in an outpatient surgical center. Max could not work for two weeks and lost $2,000 in earnings.

Question: In the event that a surgeon is not within the network, how would Max handle the responsible for his charges?