Preferred Provider Organization (PPO)
Regenexx Benefits
Under a PPO, you have coverage both in-network and out-of-network. You can see any doctor you choose, you don’t have to select a primary care physician (PCP), and you don’t need referrals to access specialists.
Under a PPO plan, you can:
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Stay in-network and save money by using a network provider. Your out-of-pocket costs are lower because network providers typically offer their services at lower rates. In addition, you receive a higher level of benefits when you visit in-network providers.
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Or, go out-of-network and use any doctor or hospital you’d like, but pay a greater share of the cost. You may be subject to reasonable and customary (R&C) limits.​
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Click image to view the coverage chart:
Network:
Alliance Select
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Group Number:
56851-0319 GreenState PPO
56851-0419 GreenState HDHP
56851-0309 Insurance PPO
56851-0409 Insurance HDHP
56851-0329 Trust PPO
56851-0429 Trust HDHP
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Website:
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Support:
1.800.524.9242
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Claim Submission Address:
Wellmark BC/BS of IA
Station 39
636 Grand Avenue
Des Moines, IA 50309-2565
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(Plan pre-fix: LDS)
In-Network Coverage
Most covered services are reimbursed at 80% after you meet the annual deductible.
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Under the GreenState Traditional PPO, there is a $20 copayment for each office visit to a primary care physician, chiropractor, occupational therapist, physical therapist, speech pathologist, and mental health and chemical dependency treatment. There is also a $40 copayment for each office visit to a specialist.
Out-of-Network Coverage
Most other covered services are reimbursed at 70% of the reasonable and customary costs, after you meet the annual deductible.
Important Note: You are responsible for all out of-network charges above the reasonable and customary limits, even if you have reached the out-of-pocket maximum.