About Trident Medical Network

Trident Medical Network is a medical network located in California.  It is a health care delivery system that contracts with providers of medical care to provide health care services at discounted fees to Members or enrollees.  Members may also seek care from non-participating providers but often are financially penalized for doing so by the loss of the discount in addition to higher co-payments or deductibles.  The insured Members may incur higher out-of-pocket expenses for covered services received outside the PPO if the outside charge exceeds the Trident PPO payment rate.  While many insurers will offer PPO’s as well as HMO’s, generally PPO’s will offer more choice for the patient and will provide higher reimbursement to the participating providers.

Another common Health Plan found in many communities is referred to as a Point-of-Service Plan (POS) – A health services Plan that offers this option for its Members to choose and receive services from either participating or nonparticipating providers.  Generally, the level of coverage is reduced for services associated with the use of non-participating providers and usually Plans specify that those patients who go outside of the PPO Plan for services may pay more out-of-pocket expense.  A benefit of the Point-of-Service Plan is that Members or subscribers can select between different delivery systems (i.e., HMO, PPO and fee-for-service) when in need of health care services at the time of accessing the services, rather than making the selection between delivery systems at time of enrollment.  Usually, the costs associated with receiving care from “in network” or an approved provider is less than when rendered by non-contracting providers.  Or, the costs are less if provided by approved providers in either the HMO or PPO rather than “out-of- network” or “out-of-plan” providers.  This is a method of influencing patients to use certain providers without restricting their freedom of choice.