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What is a PPO?


Preferred Provider Organization is an abbreviation for this concept. A PPO plan’s network of doctors and hospitals is similar to that of an HMO, or health maintenance organization. These doctors and hospitals have contracted to treat plan participants at a discounted rate.

Still, there are a few key distinctions. Let’s go over the essentials of a PPO plan and how to determine if it’s the best option for you.

More flexibility

In contrast to health maintenance organizations (HMOs), PPOs allow you to see any doctor or hospital you like, regardless of whether they are part of your network or not. Your choice of primary care physician, specialist, and healthcare facility is unrestricted.

As a bonus, PPO plans do not call for you to select a PCP or demand referrals. If you’re happy with your current physician, for instance, you can keep seeing them.

You don’t have to make an appointment with your primary care physician (PCP) before seeing a specialist. There is no need to get a referral before seeing a general practitioner, specialist, or hospital.

Another perk is that you can visit any doctor you want if you get sick while traveling.

Higher costs

While a PPO health insurance plan may give you more flexibility, it also comes with higher out-of-pocket expenses.

Both your regular monthly premium and your copayments for doctor’s visits will increase. Additionally, a yearly deductible must be paid.

Remember that if you want to save money on healthcare, you should only see doctors and other professionals who are part of your PPO network.

Getting a plan

If a PPO sounds like the way to go, you can compare different options on Medicare Advisors. You can check out the various options for coverage in your area and buy a plan right here on the site.

Medicare Advantage PPO plans are available to those who are Medicare-eligible. 

Is PPO right for you?

If you value freedom of choice and are willing to pay more for it, a PPO may be the best option for you. For those who do a lot of traveling, not having to maintain a primary care physician is an obvious plus.

Finding the right plan for you requires balancing your desired level of coverage with the cost of the premium.


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