Medical PPO

A medical PPO is a type of managed health care plan. Other managed health care plans include Health Maintenance Organizations or HMO’s and Point of Service Plans or POS’.

A Preferred Provider Organization, or PPO, is a health insurance option that may be provided through an employer or purchased through and individual health insurance plan. A PPO is similar to an HMO, in that it provides employers with a way to provide health care for their employees at negotiated reduced costs. There is a wide rage of

PPO vs. HMO

The single largest difference between an PPO and an HMO is that PPO’s are very flexible and allow members to choose any doctor they like without having to get a referral (and members can even receive care out of network) while HMO’s typically require a member to accept a primary care physician (PCP) and to see other Doctor’s only with a referral from their PCP. Also, HMO’s usually do not offer out of network benefits. POS network can take on the form of either a PPO or an HMO as they are a type of hybrid between the two and can vary quite a bit from one POS to another.

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Some Medical PPO Benefits

As mentioned above, some managed health care plans require you to choose your doctor from a list. However, with a PPO you have the option of choosing your hospital and doctor. You can also see specialist without a referral, so there is no need to select a primary care physician.

Medical PPO Coverage

Some common coverage options for a medical insurance PPO include:

Doctor’s Appointments
Inpatient And Outpatient Hospital Care
Maternity
Breast Cancer Screening
Cervical Cancer Screening
Physical Therapy
Speech Therapy
Occupational Therapy
Infertility Treatment
Mental Health Treatment
Emergency Room Visits

Choosing A Doctor With A Medical PPO

While there is no pressure to choose a doctor within the PPO network, there are some benefits to choosing a PPO doctor or hospital. If you do choose a Medical PPO doctor or hospital then you will not have to fill out a claims form or pay up form costs for medical services, except when a copay is needed.

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