What Is a PPO Insurance Plan?

If your employer offers group health coverage, one of the options that may be available to you is to join a Preferred Provider Organization (PPO). A PPO is a form of managed health care organization.

Features

• If you belong to a PPO, you will be able to select from a network of caregivers, although you may elect to go outside of the network if you are willing to receive reduced benefits. You may also be required to pay a deductible and copayments, which are amounts you pay out of your own pocket before coverage begins.

Benefits

• PPOs typically offer more freedom of choice regarding coverage than other types of managed care organizations like HMOs (Health Maintenance Organizations). There is also typically no need to go through one primary care physician for referral to a specialist.

Considerations

• Although they offer a bit more freedom, the costs of PPOs may be higher for patients due to the need to pay more out of pocket. The additional costs for going outside the network can also be high.