What is a Health Insurance PPO Plan? A health insurance PPO plan is a type of health insurance plan where you have access to both in – network doctors and out-of-network doctors. A PPO plan provides more flexibility to see whomever you want. You can even see a specialist on health insurance plan, without a referral most times.
Health Insurance – PPO stands for Preferred Provider Organizations
Basically, an insurance company contracts with doctors and selected hospitals to provide services at discounted rates. As I mentioned earlier a PPO plan has both in and out of networks level benefits.
In network refers to the list of doctors that the insurance carriers have contracted with to provide you with discounted rates. An added benefit of using in-network doctors is because based on this contract they should not balance bill for services.
Unlike a HMO health insurance plan, a PPO plan has the added benefit of out-of-network services.
Cautionary note: Although you have the option to go out of network and still have some benefits, they are reduced. Additionally, any doctor/hospital etc you seek services for outside the carriers contract list of doctors, you will typically have a higher deductible and the co-insurance limits are generally twice the amount as in network doctors.
With this in mind, majority of PPO health insurance carriers have national networks. This is a huge benefit for someone who travels from state to state. If your health insurance plan has a national network, than seeking services while traveling is like being in your home state.
Please keep in mind.. with flexibility comes more responsibility on your part to ensure that you are utilizing in network doctors to keep your out of pockets as low as possible. This should be easier with a PPO plan since the network of doctors on PPO plans have several thousands to select from depending on your location.