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What Is a PPO in Health Insurance?
<lingo>A Preferred Provider Organization (PPO) is a type of health insurance where members have access to a network of professionals they can turn to when they need medical care. A PPO will negotiate rates for its members based on the provider's location, specialty, and experience. However, just because PPOs have a preferred network for members doesn't mean that members have to exclusively use those providers. PPOs are typically preferred over HMOs because members have more flexibility to see doctors both in and out of network. Due to the freedom it gives members, PPOs have higher out-of-pocket maximums than standard insurance plans.</lingo>
PPO Explained
PPOs are often chosen by people who don't want limits placed on their healthcare. If you're out of town and need unexpected medical care, you won't have to worry about whether your bills will be covered because the provider was out of network. If you already have a doctor who knows your history, you don't have to worry about starting over again with a new team. If you need to see a specialist, you won't have to get a referral from your primary physician like you would on most other plans. This creates the flexibility that many people need to manage their own care, without having to check websites and make endless calls or office visits to secure referrals.
<twitter>A Preferred Provider Organization (PPO) is a type of health insurance where members have access to a network of professionals they can turn to when they need medical care. </twitter>
Your plan's terms will largely depend on your budget and your individual health risks. For example, smokers will typically pay more than non-smokers for the same rate of care. All PPO plans will have co-pays and deductibles that determine how much money you spend on healthcare per year. If you want to save money on out-of-pocket expenses, you'll need to stay within the network. So even though you can see whoever you choose, it's still financially better to use the network doctors and professionals available through your plan. PPOs can be purchased at a variety of coverage levels through most health insurance companies. Even Medicare Advantage offers PPO plans to members who qualify.
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