Why Choose a PPO Over Another Type of Health Insurance?
A PPO does not restrict a patient’s choice of doctor. Unlike a PPO, some other types of insurance plans refuse to cover visits to a doctor who does not belong to a network. A patient who belongs to a PPO can receive some PPO coverage for visits to almost any doctor, even if the doctor does not participate in a network. A PPO often does not require a patient to get a referral from a primary care doctor before the patient sees a specialist. The patient can go directly to a specialist without involving a gatekeeper. The PPO does provide an incentive for people to use PPO participating doctors by requiring lower co-payments and lower coinsurance amounts when visiting PPO participating doctors. For example, a PPO might cover eighty five percent of the cost to visit a doctor who is in a PPO network. The PPO might only cover fifty percent of the cost to visit a doctor who does not participate in a PPO network. The ability to get coverage for a patient’s choice of doctors can make PPO coverage
