the Price of Health Insurance from a PPO

I have PPO coverage from a state administered program that helps to make health insurance more affordable for Mainers. My In-Network copay is 25 dollars per visit, and I pay $10/$30/$50 for prescriptions, depending on the medications cost. Athough I got this plan through the state administered program, it is real, private insurance, not a program like Medicaid. I pay 72 dollars a month for this insurance, and there is no contribution from my employer. There is really no way I could get this coverage on my own without programs like these.

Overall, my coverage and service are great. I've found that the billing department doesn't always have its act together. Several times I've been told my coverage was canceled for non-payment, even though I'd already paid. They're very helpful when I call, and I've never actually lost my coverage. As far as I can tell, that will keep happening, but it has not affected my coverage, so I can't really complain.

As for the quality of coverage, I haven't had any real issues. I've got to pay the full 50 dollars a month for my particular medication every month, which is too bad. Most of my doctors are covered. When I had a small surgery in 2006, the co-pay was very high, like 500 dolllars.

If you're going to get help from the state with your insurance, there are only certain times of year you can enroll, I think it is the end of December. If you've got to have surgery or other major medical care, be sure to find out how much your copay will be BEFORE you get the procedure done! I learned this the heard way!