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AHIP Medicare Exam Prep 13, Medicare Advantage PPO Rules
Published 1 month, 2 weeks ago
Description
This podcast is made by Ran Chen, who holds an EA license, Insurance and Securities licenses (Series 6, 63, 65), and the CFP® designation. He is passionate about opening access to high-quality exam preparation resources and helping learners prepare more effectively for professional certification exams.
In this episode you will learn:
- Out-of-network providers are not obligated to treat PPO members for non-emergency or non-urgent care.
- PPO plans do not require primary care physician selection or specialist referrals.
- Differential cost sharing results in higher out-of-network copayments and coinsurance.
- PPO rules require both an in-network MOOP and a combined in-network and out-of-network MOOP.
- The FLEX mnemonic for remembering key PPO exam rules and avoiding common test traps.
For more free exam prep tools, practice questions, and AI-powered explanations, visit https://open-exam-prep.com/ or YouTube Channel: https://www.youtube.com/@Open-exam-prep