PPO (Preferred Provider Organization)

PPO health insurance plan lies between HMO and pure fee-for service plan. A PPO is a managed care plan, where you get the degree of choice regarding which provider to use. It s similar to HMO in the aspect that you have to pay a certain premium amount and in return health insurance company provides you the basic medical benefits.

In PPO plan, it is not necessary to visit a primary physician and moreover, visit to a specialist does not require any referral. But, instead if you need a healthcare from outside, you need to pay higher co-payment.

Pros of availing PPO plan

Out-of-pocket cost is limited
Healthcare cost remains low, when staying within network.
You can consult any specialist either inside or outside of the network.
Primary care physician is not a prerequisite.

Cons of availing PPO plan

Cost of treatment outside network is expensive
In case of treatment in non-network of hospitals, you have to complete paperwork.
Co-payments are higher.