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What is a Preferred Provider Organization (PPO)?

The pros and cons of a PPO health care plan

A Preferred Provider Organization (PPO), is a group of health providers who contract with an insurer to provide health insurance coverage at a reduced rate to policyholders represented by the insurer.

A PPO offers you more flexibility in choosing which health care providers you see. You have the freedom to receive care from providers both in-network and out-of-network. You can usually visit specialists without a referral, including out-of-network specialists.

PPO plans are generally more expensive than health maintenance organizations (HMO) plans. Overall, think higher cost with greater flexibility to choose your team of health providers.

PROS OF A PREFERRED PROVIDER ORGANIZATION (PPO)

  • No need to select a Primary Care Physician (PCP)
  • No referral needed to see a specialist
  • Usually some out-of-network coverage

CONS OF A PREFERRED PROVIDER ORGANIZATION (PPO)

  • Higher Premiums
  • Usually have a deductible