What is a PPO?
A Preferred Provider Organization (PPO) is an arrangement designed to supply health care services at a discounted cost by providing incentives for members to use designated health providers (who contract with the PPO at a discount), but which also provides coverage for services rendered by health care providers who are not part of the PPO network.
PPO or Preferred Provider Organization gives you the freedom to choose your primary care or other physician from an extensive network of participating doctors and healthcare facilities allowing you to share in substantial cost-savings. You can even choose to receive your healthcare from an out-of-network provider; however, you will share more of the cost.
A PPO is a preferred provider network. This means that the plan offers two levels of benefits coverage: in-network benefits and out-of-network benefits. If a member uses providers within the plan’s network (in-network benefits) they receive a higher level of coverage than if they use providers who are not within the plan’s network (out-of-network) benefits. This differs from an HMO or an EPO in that in an HMO or EPO out-of-network coverage is not available.
This stands for Preferred Provider Organization. Basically, this is a network of health care providers who have agreed to provide certain services at agreed-upon costs for individuals whose coverage is a part of the network. (Some suggest it is best described as a discount-buying club for medical care.) You are free to use any medical provider within the network, and all will honor the agreed services and fees. If you choose to use a provider who is not an approved member of the network, your coverage may be diminished, your personal cost higher or, in some cases, benefits for non-emergency services may be totally denied. Be sure to discuss with your Trusted Choice® agent if your coverage will utilize one or more PPOs, who are the current approved providers, and how utilizing an out-of-network provider will affect your coverage.
