PPO - Preferred Provider Organizations

A PPO (otherwise known as a preferred provider organization) is a popular form of health insurance. This type of plan has a reputation as a well-balanced form of insurance because it includes consumer choice at a reasonable price. A PPO falls somewhere between indemnity plans and HMOs in terms of both cost and availability of services.

PPOs allow members to choose between preferred provider networks or the health care provider of their choice. PPO members are never required to use the doctors within the network but, if they choose to, they are entitled to generous discounts. Should a member opt to visit a doctor from outside of the network, they are still entitled to receive some provisions under the plan.

Why would anyone want to go out of the preferred provider network? Sometimes, the network does not include your lifelong doctor or specialist recommended to you by a highly credible source; other times you may be traveling and not have access to a “network provider” or unable to schedule an appointment with a “network provider” soon enough to meet your needs. Generally, preferred provider networks work through the referral system and, to some patients, the time it takes to receive a referral can seem like an eternity.

HMOs, the other major form of managed care, work solely within the described “networks of preferred providers.” When HMO plan members leave the network, essentially, they are surrendering their insurance coverage. Under PPO plans, members are not so tightly restricted as the coverage is much broader and list of providers much more extensive.

As one would expect, PPO plans, in comparison with HMO plans, do tend to cost a bit more. But it is important to keep in mind that PPO plans do also provide more generous coverage, in addition to, broader access to healthcare providers.

While consumers on extremely tight budgets will probably find HMO plans to be a better fit; others with less pressing financial concerns, may find PPO plans to be more to their liking. Those who are willing and able to pay slightly increased amounts for their health insurance coverage are bound to be pleased with the flexibility PPO plans have to offer. For those who want to see medical professionals of their own choosing, PPO plans tend to be worth the added expense.

To find out the specific coverage contained under a PPO plan and your available options; take a few minutes to fill-out an online questionnaire and get your free online quotes within minutes.