The open choice preferred provider organization plans offered by Aetna are PPO 1 and PPO 2, states Inova Health System. The main difference between these two plans is the amount the patient has to pay for co-pays and coinsurance.
The open choice preferred provider organization plans from Aetna are ideal for individuals who want flexibility to choose their own provider and want to visit specialists without referrals from their primary care physician, according to Inova Health System. Patients who want to control their health care costs can use network providers, while those who are willing to pay more can have more choices.
With the open choice preferred provider organization plans, patients do not have to choose a primary care physician, and they can go to any licensed health care provider within or outside the Aetna network, explains Aetna.
Patients pay less in co-pays, coinsurance and deductible costs if they choose a participating member, notes Inova Health System. The patient pays a fixed amount for routine exams and doctor's visits. An additional benefit of choosing in-network providers is the provider files the claim on behalf of the patient and takes care of all precertification requirements. Patients who choose out-of-network providers have more flexibility, but they pay higher deductibles and co-pays, and they file their own claims. Patients who use the open choice PPO plans may have to pay the balance if the provider's charges exceed Aetna's maximum allowable amount for the service.