PPO Health Plan - How does it Function?

A PPO health plan uses an organization of physicians to keep health costs low. PPO stands for preferred provider network. When you are a member of a PPO, you can use any physician in that network for services at a low cost.

PPO Basics

Once you elect PPO coverage, you will get a card that proves you are part of a network. You can check to see which doctors is a part of your network by searching the PPOs website or calling a doctor directly. You do not need an approval to a primary care physician with a PPO. This flexibility can make PPO insurance slightly costlier than other options, but people who elect it want the flexibility.

PPO versus HMO

An HMO is another health plan option similar to a PPO. The main difference with an HMO, or health maintenance organization, is an HMO must approve your visit to a doctor before you go. This means you must register a specific physician as "your" doctor with an HMO. If you see another doctor, you must first get approval from the group. You may save a little money with this option, but it is much more restrictive overall.

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