What is a Preferred Provider Organization (PPO)?

A Preferred Provider Organization (PPO) is a type of health insurance plan that emphasizes flexibility in choosing healthcare providers. One of the key characteristics of a PPO is that it does not require members to obtain referrals from a primary care physician to see specialists. This aspect allows individuals greater autonomy in their healthcare decisions, enabling them to seek care from a broad network of providers without needing prior approval.

Additionally, while PPOs often offer lower costs for services when members use in-network providers, they still provide the option to see out-of-network providers, albeit typically at a higher out-of-pocket expense. This network structure combines the benefits of both managed care and traditional fee-for-service plans, making them popular among individuals who prioritize choice and flexibility in their healthcare options.

The other options present features of different types of health insurance plans. Referrals for specialist visits are typically associated with Health Maintenance Organizations (HMOs), and restricting network access aligns more closely with Exclusive Provider Organizations (EPOs) or some managed care arrangements that focus on cost control. Meanwhile, insurance that only covers emergency services usually pertains to specific limited benefit plans rather than a comprehensive structure like a PPO.