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PPO Health Plans — What Are They?

People choose Preferred Provider Plans for their healthcare coverage for many reasons. Two of the biggest are affordability and flexibility.

PPO plans are managed care organizations. To keep costs down, limits are placed on which doctors plan members can go see. These plans also place an emphasis on preventive care at the primary level — meaning regular checkups with your physician. By keeping their members healthy, PPO plans keep costs down for everyone.

PPO plans usually have lower premiums and deductibles than traditional health insurance plans. They give you the convenience of having many doctors and hospitals to choose from. And unlike other managed care programs, in a PPO you typically don’t need prior approval to see a specialist.

PPO Advantages

These are the advantages of PPO programs:

    • Limited out-of-pocket expenses
    • No referrals required from your primary care physician to see specialists
    • Low costs when you use healthcare providers within the network
    • You save money even when you use a provider outside of the plan network

Important Points About PPO Plans

In a PPO plan, you’ll get two levels of benefits. The first level is for care received from doctors, hospitals, and other providers within the network. The second is for care received from providers outside the network.

No surprise here: the plan benefits are greater for using providers within the network. But one of the advantages of PPO plans is that you can use an outside provider, and still have some of the cost covered. In some other plans, none of the costs will be covered if you go outside the network.

PPO plans also tend to have lower deductibles and co-payments than traditional healthcare plans. The tradeoff for these lower costs is that more restrictions are placed on the kinds of care that will be covered. But if you’re generally healthy, you may want to choose a PPO plan.

You can learn more about PPO plans, or start talking to agents to get started with your own coverage. If you’re ready to get matched with agents, get your free quotes now.