Preferred Provider Organization (PPO)

A PPO is a managed health care program that uses a network of physicians and hospitals that provide services to the PPO members. Typically, the company that is providing the benefits develops a discount arrangement with the provider, saving the members money in premiums. PPOs are less restrictive than other types of managed care programs, such as point of service plans or health maintenance organizations. Usually, PPOs still provide some benefits if the member sees an out-of-network provider.

SUPER BLUE PLUS

Mountain State's PPO, Super Blue Plus, offers a comprehensive network of providers working together to provide care. Our network of providers consists of physicians, hospitals, physician-hospital organizations, ancillaries, etc.

Mountain State uses provider selection standards, utilization management and quality assessment, along with negotiated payment rates, to receive maximum value for the member's dollar.

Members receive the highest level of benefits and lowest out-of-pocket expense when they see a preferred provider. Members have the choice of receiving care from either a PCP or a specialist without a referral.

Through the Blue Cross and Blue Shield Association's national network of Blue Cross and Blue Shield plans, more than 18.8 million Plan members receive care in PPO programs from more than 6,000 hospitals and 558,000 physicians.

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