Managed care
In terms of using such a plan, unlike an HMO plan, which has a copayment cost share feature (a nominal payment generally paid at the time of service), a PPO generally does not have a copayment but offers a deductible and a coinsurance feature. The deductible must be paid in full before any benefits are provided. After the deductible is met, the coinsurance benefits apply. If the PPO plan is an 80% coinsurance plan with a $1,000 deductible, the patient pays 100% of the allowed provider fee up to $1,000. The insurer will pay 80% of the other fees, and the patient will pay the remaining 20%. Charges above the allowed amount are not payable by the patient or insurer but written off as a discount by the physician.
Tax-deductible loss
According to the United States Internal Revenue Code certain losses are deductible for tax purposes. To qualify, the loss must not be compensated by insurance and it must be sustained during the taxable year. If the loss is a casualty or theft of the personal, family, or living property of the taxpayer, the loss must result from an event that is identifiable, damaging, and sudden, unexpected, and unusual in nature. Examples are hurricanes, tornadoes, and floods. A house that suffers from termite damage would not generally qualify because it is considered to be gradual and progressive. The loss is reduced by a $100 per event and the total loss might be reduced by the 10% of adjusted gross income floor.