How Is a PPO Helpful?
While researching health insurance, you might have heard of a PPO plan. A PPO plan is a popular and common kind of health insurance that partners with groups of clinics, hospitals, and doctors to develop a network of preferred providers. With PPO insurance, you will pay less out of pocket when you get care within that network. You are still able to see an out-of-network provider, but you will get the most coverage if you stay within the PPO network. PPO health plans can be a good fit if you live in two different states or travel often within the U.S.
What Does PPO Stand For?
PPO stands for “preferred provider organization,” which refers to the network of contracted PPO providers. The plan’s preferred providers are those who will offer care to you at the lowest out-of-pocket cost, in comparison to out-of-network providers.
How Does a PPO Work?
A PPO plan performs like many other health insurance plans. The plan pays the contracted providers an established cost to offer certain health care services, allowing you to pay a lower cost-share, like a copay or coinsurance, when you get your care within the network. If you receive care outside the network, you will pay more and will most likely need to submit a claim. You will also need to meet an out-of-network deductible before your plan benefits begin. This is separate from your deductible for network care.
What is the Advantage of a PPO Plan?
Basically, you get more flexibility with a PPO plan than with some other plan types. That could be why you may choose this type of plan. PPO plans come with many benefits, including:
- Usually, it has a large, nationwide provider network.
- No referrals are needed.
- Out-of-network coverage available.
- No requirement to choose a primary care provider.
What is the Difference Between an HMO and a PPO?
An HMO, health maintenance organization, plan is another common health plan. HMO plans only cover services you receive from a network provider, except for emergency care. This means if you see an out-of-network provider, you will have to pay the full cost of the visit. Usually, HMO plans have lower premiums than PPO plans. It is important to understand the differences between HMO and PPO plans.
What is a PPO Dental Plan?
PPO dental insurance is much like a PPO health plan. A dental PPO plan will have a list of preferred dental providers you can use at a lower cost. You still have the freedom to see any provider you wish, but you will pay more out of pocket if you see an out-of-network dental provider.
Keep in mind, PPO plans are just one kind of health insurance plan available for you and your family. The other three basic types of networks and health plans include HMO, EPO, and POS health plans. Take the time to do your research to understand the pros and cons of each so you can choose the best fit for your individual needs.
Learn about our payment and financing options here.