what is a ppo health plan

what is a ppo health plan

1 year ago 50
Nature

A PPO, or Preferred Provider Organization, is a type of health plan that contracts with medical providers, such as hospitals and doctors, to create a network of participating providers. PPO plans offer a network of healthcare providers that have agreed to provide care to plan members at a certain rate. The key features of a PPO plan include:

  • Network of Providers: PPO plans have a network of doctors and hospitals that you can visit. Providers in the network agree to accept lower payments in exchange for access to patients in the insurer’s network.

  • In-Network and Out-of-Network Care: You pay less if you use providers that belong to the plan’s network. You can use doctors, hospitals, and providers outside of the network for an additional cost.

  • Flexibility: PPO plans offer more flexibility than HMO plans. You dont need to select a primary care physician, and youre not required to get a referral to see a specialist.

  • Cost: Cost can vary depending on the providers you go to. If you stay in the PPOs preferred provider network, your costs are less. If you choose to go to a provider outside the PPO network, you pay much more.

Compared to HMO plans, PPO plans are generally more expensive but offer more flexibility in choosing which healthcare providers to see.

Read Entire Article