Healthcare News | Care411

PPO

Michael March 1, 2012

Preferred Provider Organizations

Preferred Provider Organization is a managed health care organization of doctors, hospitals and other healthcare providers that offer health insurance coverage in the U.S. PPO is a subscription-based medical care program which offers its members access to highly-qualified medical professionals who have agreed to offer them medical care at reduced rates. Under the PPO plan, an employer can provide employees with reduced health care costs billed to their health insurance plan. The member provider in the PPO’s network would be the least expensive choice for the employee. PPO earns its own funds by charging an access fee to the insurance company for using their networks.

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Many people prefer PPO over HMO as it provides the option to pick and choose the desired health care providers. Another benefit of the PPO is that, one can choose a health-care provider outside the network but at a reduced benefit. In PPO, you don’t have to choose a PCP and seek referrals. You are free to choose any doctor, provided that you choose from the preferred ones.

However, PPOs generally tend to have higher premiums than HMOs and other plans. And they also don’t provide full coverage if you choose the health care provider from outside the ‘preferred’ network.



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