Final answer:
Patients with PPO insurance can expect to pay higher out-of-pocket costs when using non-PPO providers due to higher deductibles, co-payments, and potentially lower reimbursement rates from their insurance company. They should review their plan's details for specific coverage rules, considering the effects of moral hazard and adverse selection in their decision.
Step-by-step explanation:
What can be expected when a preferred provider organization (PPO) patient decides to use a non-PPO? Essentially, if a patient with PPO health insurance chooses to receive care from providers outside of their PPO network, they can anticipate higher out-of-pocket costs. This happens because PPO plans usually provide more coverage for care within their network of preferred providers. Choosing a non-PPO provider may result in higher deductibles, co-payments, and co-insurance rates. Additionally, the insurance company may reimburse less for services rendered by non-network providers, meaning the patient would be responsible for the balance.
Particular plans may have different coverage rules and costs associated with seeing non-PPO providers, and patients should check the details of their insurance plan. It's also important to consider the concepts of moral hazard and adverse selection. In terms of adverse selection, patients with a higher risk of needing medical care might choose PPO plans since they offer a wider range of providers, while those with lower health risks could prefer less expensive options. Moral hazard refers to the tendency of individuals to consume more medical services when the services are covered by insurance; however, the presence of deductibles and copayments can mitigate this effect.