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Typically, PPOs offer flexibility comparable to that of an FFS. A PPO has arrangements with doctors, hospitals, and other health care providers who have agreed to accept lower fees for their services from the insurer. As a result, cost sharing is lower for plan members within a PPO network. Network health care providers make referrals, but plan members can self-refer to doctors and specialists, including those outside the plan.

Participants who visit network doctors pay copayments, or set amounts for certain services; individuals who venture outside the network pay higher fees in the form of deductibles and copayments. PPO members are also required to make up the difference between what their personal provider charges and what the health care plan pays.

Preferred Provider Organizations

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