Preferred Provider Organization
A health plan with a broad discounted network that still covers out of network care at a lower share.
Overview
Members can see specialists without referrals, the main convenience over HMOs. In network care might be covered at 80 or 90 percent after a deductible while out of network claims face a separate higher deductible and coinsurance, and balance billing above allowed amounts can add large bills. Premiums run higher than comparable HMOs. PPOs became the most popular US employer plan type because of that flexibility, though cost pressure has pushed employers toward tiered and narrow network variants. They fit people who travel, see specialists often, or want to keep a particular doctor regardless of network participation.
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