Preferred Provider Organization

If you have a Preferred Provider Organization (PPO) health plan, you can see a doctor inside or outside of your PPO network.  But if you choose a doctor outside of your network, you will most likely have to pay more.  The good thing about PPOs is that you do not need to see a primary care doctor before seeing a specialist.  So, for instance, if your chest has been hurting, you can go straight to a cardiologist instead of having to see your primary doctor first to get referred to a cardiologist.

The bad thing about PPOs is that you usually have a deductible on top of a copayment.  And even after you’ve met the deductible, you might still have to pay a coinsurance.  Plus, some doctors require you to pay them upfront and file a claim afterwards with your provider to get reimbursed.

Even with these extra costs, if money isn’t tight, most people still prefer a PPO plan over a HMO plan for the flexibility.

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