Preferred Provider Organization (PPO)
Insurance Glossary
A health plan that pays the most for care from providers in its network but still covers out-of-network care at higher cost sharing, with no referral needed to see a specialist. That flexibility usually comes with a higher premium than an HMO or EPO carrying a comparable deductible. Out-of-network care is paid against the plan's allowed amount rather than the provider's charge, so a patient can end up owing more than the coinsurance percentage alone would suggest.
This content is for general informational purposes only and is not insurance, legal, or financial advice. Coverage, exclusions, eligibility, and pricing vary by insurer, by policy, and by state, and only the policy documents control what is covered. Always confirm the details of any coverage with a licensed insurance agent or the issuing carrier before you buy.