PPO stands for Preferred Provider Organization. A PPO plan gives you access to a network of doctors and hospitals who have agreed to reduced rates, but unlike an HMO, you're not locked into that network.
How a PPO works
You can see any healthcare provider you choose, in-network or out-of-network, without first selecting a primary care physician and without a referral to see a specialist. Staying in-network keeps your costs lowest, but out-of-network care is still covered — typically at a lower reimbursement rate.
What makes a PPO different
- No requirement to choose a primary care physician
- No referral needed to see a specialist
- Coverage for out-of-network care, at a higher out-of-pocket cost
- Generally higher monthly premiums than an HMO, in exchange for flexibility
Should I choose a PPO plan?
A PPO is often the right fit if you already have a doctor or specialist you want to keep who may not be in every network, if you split time between two cities, or if you simply value the freedom to choose your own care team. If keeping your premium as low as possible matters more than flexibility, it's worth comparing a PPO against an HMO or EPO plan side by side.