PPO Health Insurance

PPO stands for Preferred Provider Organization. It is a health care organization which is organized by a particular insurance company. The doctors, hospitals, and clinics are contracted by the insurance companies to work with the PPO plans. The PPO determines the fees and medical guidelines do

A PPO is similar to a health maintenance organization (HMO) in that it offers a network of health care professionals available to the insured person; however, a PPO is more flexible than an HMO in that a PPO also offers the option of seeing an out-of-network health care professional. Many times people would rather visit their family doctor, or a doctor that is highly recommended, than a doctor in the PPO network with whom they may not be familiar. Yet, PPO networks usually represent a high number of medical professionals, doctors, and clinics over a large geographic area, so finding an agreeable doctor might not be that difficult.

The insurance offered by a PPO usually covers a high percentage of the cost to see a health care professional in the PPO network, and the insured person will pay a co-payment at the time of the doctor, hospital, or clinic visit. Fees for out-of-network health care professionals are often higher than fees for seeing a health care professional in the PPO network. PPOs want to encourage the insured person to visit a doctor within the network, but it is obviously not required. PPOs also require the insured person to pay a yearly out-of-pocket fee before medical bills will be covered.

Other advantages to a PPO are the fact that its premium is less expensive than that of an individual health insurance plan and the fact that PPO networks usually have a plan that will offer prescription drugs at much lower costs. A PPO will also cover more medical services than an individual health insurance plan.