Pros And Cons Of PPO Health Insurance
PPO Health Insurance

PPO health insurance (Preferred Provider Organization)is a compromise to traditional HMOs (Health Maintenance Organizations) and private fee-for-service insurance companies. Fee for service offers the most freedom in choice, but also provides for less overall expenses than HMOs. HMOs on the other hand, pay for smaller expenses but strictly limit your dealings to a network of physicians. PPO health insurance is a go-between plan that may suit you.

With PPO health insurance plans your health care is managed by the company (which operates similarly to an HMO) but you are given back the freedom to choose your providers and physicians. You also pay a monthly premium and the network provides basic medical benefits. A PPO also different from an HMO in that a primary care physician is not required, nor is a referral if you want to see a special of your choosing. You are free to choose someone outside the network, though you might incur higher costs.

Pros To PPO

PPO health insurance has its advantages. In general, the costs of health care insurance are low, given that you stay within the recommended network. Yet, you are also given the freedom to choose any specialist you want, even one that is outside of the PPO plan. You are not required to see a primary care physician before seeing a specialist. Lastly, your out-of-pocket expenses are limited. PPO plans are affordable and flexible.

Cons To PPO

However, PPO health insurance also has its setbacks like any other plan. If you travel outside the network of providers or physicians, you will pay more. Co-pays are also more expensive, in general, and more so if you travel outside the network. Deductibles could be high and must be paid before the PPO will cover other expenses. Finally, if you travel outside the network, you personally must handle all paperwork and other preparation.

PPO health insurance does have a lot of positives, depending on what options are important to you. If you have special need of going outside a given network and choosing your own specialists, then a PPO plan may suit you.