A Preferred Provider Organization is a health plan that gives you more flexibility to see any doctor or specialist without a referral. You pay less when using in-network providers, but you still have partial coverage for out-of-network care. PPOs typically have higher premiums than HMOs.
Related Terms
EPO
An Exclusive Provider Organization is a managed care health plan that covers services only from its network of doctors and hospitals, except in emergencies. EPOs typically do not require referrals to see specialists, offering more flexibility than HMOs while still keeping costs lower than PPOs.
HMO
A Health Maintenance Organization is a type of health plan that requires you to choose a primary care physician (PCP) and get referrals to see specialists. HMOs typically have lower premiums and out-of-pocket costs but limit coverage to in-network providers except in emergencies.
In-Network Provider
A doctor, hospital, or other health care provider that has a contract with your insurance plan to provide services at negotiated, discounted rates. Visiting in-network providers almost always costs you less than going out of network.