What is a preferred provider organization (PPO)?

A preferred provider organization, or PPO, is characterized by its flexible approach to healthcare providers and choices for participants. It is a type of managed care plan that allows members to obtain services from both in-network and out-of-network providers. While going out of network may result in higher out-of-pocket costs, PPO plans enable members the freedom to see any healthcare professional without needing a referral from a primary care physician. This contrasts with some other managed care plans that impose restrictions on specialist visits or require referrals, granting PPO members a higher level of autonomy regarding their healthcare choices.

The essence of a PPO lies in its balance between cost control and patient choice, aiming to provide comprehensive care while allowing individuals to select providers that best meet their needs, whether they are part of the preferred network or not.