Preferred Provider Organization (PPO):
A type of health plan where you pay less if you use providers in the plan’s network. You can use doctors, hospitals, and providers outside of the network without a referral for an additional cost.
The Preferred Provider Organization plan offers a free choice of any primary care doctor within the carrier network. PPO plans can provide benefits up to a high limit with no lifetime maximum. PPO plans generally have a deductible, once the deductible is met the insurance company carrier will pay a percentage of the “usual and customary” charges for the covered service. In most POP the carrier pays 80% and the employee pays 20%. PPO plans usually include an employee co-pay for different medical services. PPO plans include Out-of-Network benefits at a lower carrier reimbursement rate than In-Network plans.