If you’ve spent even a few minutes researching health insurance plans or looking over your health benefits, then you’ve come across PPOs. As popular as these plans may be, there’s a chance you’re still not exactly sure how they work. Here’s what you need to know.
What Is a PPO?
PPO stands for preferred provider organization. The doctors, specialists and hospital systems in this network have agreed to provide care at predetermined rates that are outlined in the Summary of Benefits and Coverage document you receive when you enroll.
One of the PPO’s main advantages is its flexibility. With a PPO, you can choose health care providers from both inside and outside of your network, and in many cases you’re not required to choose a particular primary care physician (PCP) when you enroll. In fact, you can visit any primary care doctor you’d like — something that may come in handy when you’re out of town or your regular PCP is booked. You can also typically make a specialist appointment without the PCP referral that some other plans require.
What Else Do I Need to Know?
The main drawback of PPOs is their cost — overall, they tend to have higher copays and monthly premiums. And even though you have the flexibility to see any doctors you want, in-network options will still save you money.
Should you choose a PPO over other options, like an HMO? That’s a question your broker can best help you answer. They’ll consider factors like your budget and how diverse your medical needs are to tell you whether a PPO will give you the most bang for your buck. If you like the idea of being able to access all of your health care providers without some of the red tape, a PPO might be your best bet. Nothing beats the peace of mind you get when you know that no matter what doctors you see or where you go, you’re always covered.