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The Curious Bag
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A preferred provider organization, or PPO, is one of three managed-care health insurance plans available in the United States. People who purchase this type of plan will have the ability to control their medical costs.
Facts
PPO plans have fewer restrictions than the other managed-care plans--health maintenance organizations, or HMOs, and point-of-service plans, or POS. According to the Kaiser Family Foundation, 61.9 million people were enrolled in a PPO plan in 2009.
Benefits
PPO members are not required to choose a primary care physician from a network of doctors provided by the plan's sponsor and do not need a referral to see a specialist.
Considerations
PPO members who stay in-network to receive their medical care will have lower out-of-pocket expenses than if they go out of network.
Misconceptions
Unlike other managed-care plans, services that are performed by PPO network physicians are not prepaid. Instead members pay for them as they are rendered.
Warning
A PPO member who receives care from an out-of-network doctor may have to pay up to 50 percent of his medical bill. In some cases, the member may have to pay the entire cost and submit a receipt to the insurer for reimbursement.
Source:
Understanding the Difference Between HMO, PPO and POS
More Information:
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