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The conflict included a lawsuit by Highmark against UPMC alleging that UPMC over-billed it by $300 million for cancer drugs, [9] [10] arbitrators ordered Highmark to pay $188 million. [ 11 ] [ 12 ] In 2014, a gay couple criticized Highmark for not providing family coverage to same-sex couples under the Affordable Care Act. [ 13 ]
Blue Cross Blue Shield Association, also known as BCBS, BCBSA, or The Blues, is a United States–based federation with 33 independent and locally operated BCBSA companies that provide health insurance to more than 115 million people in the U.S. as of 2022.
HMO plans also require a referral to see a specialist, but PPO plans do not. HMO plans do not usually offer out-of-network coverage. PPO plans may provide out-of-network coverage but at a higher cost.
In U.S. health insurance, a preferred provider organization (PPO), sometimes referred to as a participating provider organization or preferred provider option, is a managed care organization of medical doctors, hospitals, and other health care providers who have agreed with an insurer or a third-party administrator to provide health care at ...
PPO. The Preferred Provider Organization plan is the most popular for those with employment-based insurance (currently 47% of them, in fact). PPOs allow the most flexibility in that people can ...
A Medicare Prescription Drug plan (PDP) is an insurance policy that covers take-home medications that a doctor has prescribed. However, out-of-pocket costs usually apply. PDPs are also known as ...