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:
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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.
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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.
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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.
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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.