What is a PPO?

Host: What is a PPO?

Bob Hurley: A PPO is acronym for Preferred Provider Organization and this also is a network system that health insurance companies will typically, use in order to contract with a set number or a set group of doctors of hospitals and pharmacies. However, in a PPO the networks are typically much larger and much broader than you would find in a Health Maintenance Organization. So PPO networks are typically are very large often, national and give you a lot more flexibility as to where you go to seek out your own care, you have a lot more. You typically don't have gatekeepers in PPOs, you can typically choose whatever doctor you want to choose within that network of doctors or pharmacies or hospitals and so on and the rates that you are going to get from that provider are negotiated rates that the insurance company has already negotiated for you.

Most PPOs do have a deductible associated with them and so typically, if you are buying a PPO plan, you are buying a plan that has some deductible associated with it which means that, if you buy a PPO plan with $1,000 deductible or $1,500 deductible you are going to be coming out of your own pocket for that first $1,000 or $1,500 depending on the plan and how it works. So the PPO again, gives you more flexibility than managed care or HMOs still gives you discount in care by way of the negotiated rates that the insurance company is provided, but then obviously, gives you a little bit more power in the process as well as a little bit more financial stake in the process because of the deductibles.