PPO

Acronym for Preferred Provider Organization

A preferred provider organization is a managed care program.  With a preferred provider organization the insurance company will provide you with a list of providers to choose from, which will be the preferred providers.  If you stay within the preferred provider network, the insurance company will pay the amount stated in the policy, if you choose to see a doctor outside of the network they will pay based on the out of network percentage stated in the policy.  Unlike an HMO plan, you are able to visit other providers and still receive coverage from the insurance company, although it may be less coverage.  For instance, if you choose a doctor inside the network, the insurance company may pay 80% and you will pay 20%.  If you choose a doctor or hospital not on the preferred list, the insurance company may only pay 70% leaving you with 30% co-insurance to pay out of pocket.  Most of the time there is a stop loss to limit the amount which comes out of your pocket.  As always, please be sure to read your policy thoroughly as each policy differs.