Preferred Provider Organizations

Preferred Provider Organizations, in one way, are combination of fee-for service and Health Maintenance Organizations. In PPO you have limited choice of health providers and hospitals, just like that in HMO plan. Your PPO plan covers all medical expenses. Like HMO, you are provided with a card which you have to present at the time of your visit to doctor/hospital. When comes to co-payment, HMO and PPO are alike. Some PPO plans have a provision which makes you to pay coinsurance for certain services. Like HMO, PPO also allows you to choose a primary health provider who gives medical care to you and monitor it. Many PPOs include preventive care programs such as mammograms, regular physical examinations, mammograms, baby check-up programs and immunizations, in their plans.

The unique feature of the PPO is that it permits you to avail medical care from a doctor who is not empanelled with PPO. However, for such instances you have to fill up claim forms and have to pay for larger part of the medical expenses yourself. Many people choose this option as they need not to change their present physician to participate in a PPO.