Preferred Provider Organization (PPO)

HR Glossary for HR Professionals

Glossary of the most common HR terms and acronyms to assist professionals navigating the ever-growing and ever-changing world of HR terminology.

Preferred Provider Organization (PPO)

What is a PPO Plan?

A PPO allows for the maximum amount of freedom and an extensive plan network. With this option, you are responsible for managing your health and need no referral to see a specialist.

Does a PPO offer more flexibility?

A PPO offers you the freedom to choose where and who you receive care from– in and out of your network. Additionally, these plans do not require a primary care physician (PCP) to be chosen prior to enrollment. 

Does a PPO cost more?

Enrolling in a PPO allows you to pay less if you use healthcare providers that belong to the plan’s network. While you can still use hospitals, doctors and providers outside of the plan’s network, there will be an additional cost. 

Overall, monthly premiums are typically higher and copays for office visits often cost more. In addition, you have an annual deductible that must be met. 

To reduce these costs, it’s important to remember that using in-network providers will save you money. 

Are prescription drugs covered in a PPO?

More often than not, prescription drugs are covered in PPO plans. It’s important to ask the plan provider prior to enrolling if this is something you’re looking for in a health plan. 

How do I know if a PPO is right for me?

PPO’s are popular options for individuals who want more control over their choices and don’t mind paying more for the ability to do so. Additionally, if you are one that travels often, this plan would be right for you. 

Related Terms: Health Insurance

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