How Does PPO Insurance Work?

by Contributing Writer ; Updated July 27, 2017

PPO insurance is also known as Preferred Provider Organizations. It provides managed health care for customers. There are some limitations to this insurance such as the cost of the plans. Benefits of having a PPO plan include not being required to see your primary care physician to get a referral to a specialist and being able to see out-of-network specialists.

The benefits for having PPO Insurance is that you do not have to worry about needing to be restricted to seeing a set network of providers and referrals from a primary care physician. PPO does not require their policyholders to do this. A primary care physician is not required and there is no need for referrals for any specialized medical services. You can consult any specialist that you prefer.

Since PPO offers policyholders the most freedom, it has higher co-payments than other managed care plans. Customers may also need to pay a deductible, which can be very high. Even though you are able to use out-of-network providers, the cost of the visits may be very expensive and the out-of-pocket costs can also be high.