How does a PPO plan work?

As a member of a PPO (Participating Provider Organization) plan, you will be encouraged to use the insurance company’s network of doctors and hospitals.  These healthcare providers have been contracted to provide services to the health insurance plan’s members at a discounted rate.  You typically won’t be required to pick a primary care physician but will be able to see doctors and specialists within the network at your own discretion.

You will probably have an annual deductible to pay before the insurance company starts cover your medical bills.  You may also have a co-payment for certain services or be required to cover a certain services or be required to cover a certain percentage (coinsurance) of the total charges for your medical bills.

With a PPO plan, services rendered by an out-of-network physician are typically covered at a lower percentage than services rendered y a network provider.