PPO stands for Preferred Provider Organization. Like an HMO, or Health Maintenance Organization plan, a PPO plan offers a network of health care providers that you can use for your health care. These providers have agreed to treat plan members for a set fee.
But there are certain differences. Let’s review the key things to consider when deciding if a PPO plan is right for you.
More flexibility
Unlike an HMO, the PPO offers you the freedom to receive care from any provider in or out of network. This means that you can see any doctor or specialist, or go to any hospital.
Also, PPO plans do not require referrals or require you to choose a primary care physician (PCP). For example, if you already have a doctor, you can continue to get care from that provider.
If you need to see a specialist, you do not have to see your PCP first. No referrals are required for any doctor, specialist or hospital.
Other advantages: If you need medical care when you are away from home, you can go to the health care provider of your choice.
higher costs
A PPO health insurance plan offers more choices when it comes to your health care, but it also has higher out-of-pocket costs.
Your monthly premiums are higher and copays for office visits are higher. In addition, you must meet an annual deductible.
To keep costs down, remember that you can save money by using providers, doctors, and other health care professionals who are part of your PPO’s network.
Hire a plan
If you decide that a PPO plan is your best option, you can find a variety of plans ateHealth.com, opens in a new window. This website allows you to review the plans available in your area and purchase the one you prefer.
If you are eligible to enroll in Medicare, there are Medicare Advantage PPO plans available. You can get details aboutHumana Medicare Advantage Plans, opens in a new window.
You may also want to consider a dental PPO plan to cover the costs of your dental care. learn more aboutHumana Dental PPO Plan, opens in a new window.
Is a PPO plan right for you?
A PPO plan is generally a good option if you want more control over your options and are happy to pay a little more for the facility. It is very useful if you travel a lot, since you do not need to go to a primary care doctor.
The key to finding the right plan is striking a balance between the coverage you want and the premium you can afford.