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...More Info About PPOs
A Preferred Provider Organization (PPO) is a type of managed care plan that uses a “network” of doctors, hospitals, and other healthcare providers to make health insurance more affordable.
A PPO creates an agreement with the provider network to get discounted medical services in exchange for patient referrals and more business. The agreement results in lower premiums and deductibles for you.
Functions Of A PPO
A PPO works much like a Health Maintenance Organization (HMO). In both kinds of plans, a network of health providers are contracted to offer their services at discounted costs.
Both PPOs and HMOs use a process called utilization review — where the PPO administrators or representatives monitor the care people receive. They review whether or not care is appropriate for each patient’s condition.
The Flexibility Of A PPO
The main difference from an HMO is that a PPO offers more flexibility of the healthcare providers you can visit. An HMO restricts patients to only their network, and care from an outside healthcare provider is not covered.
In a PPO, you can go to a health provider outside of the network and still be covered. But many times going to an outside healthcare provider will bring higher deductibles and co-payments. Staying within the network will keep your medical expenses the lowest.
If you have a specific condition and need more specialized care, a PPO may be a better choice than an HMO.
PPO Advantages
If you decided that a PPO is best for, it can offer you some nice advantages:
- PPO plans will limit your out-of-pocket expenses
- You can go outside your plan network for care, and still be covered
- Most PPO plans have large networks of providers, so it's convenient to stay within the network and save
You can get free online quotes to find the right PPO plan for you. With our free quote service our agents will help you find a PPO plan that keeps you covered, and fits your budget.
