Affordable Care Act

Preferred Provider Organization (PPO) Plans

Updated on November 15, 2019


Watch our Preferred Provider Organization (PPO) video

For a quick look at how PPOs work and whether they might be a good choice for you and your family, take a look at our PPO video.

PPO stands for “preferred provider organization.” PPO plans can save you money on out-of-pocket costs in comparison to plans that let you use any provider. At the same time, PPOs give you a bit more flexibility than HMOs, or health maintenance organizations.
If you enroll in health insurance that is offered as a PPO plan, you’ll need to get your medical care from doctors or hospitals on the insurance company’s network of preferred providers if you want your claims paid at the highest level.
With a PPO, you typically aren’t required to coordinate your care through a single primary-care physician, as you are with an HMO, so you have a bit more flexibility if you need to see a specialist. However, it’s up to you to make sure that specialists and any other health-care providers you visit do participate in your PPO network.
If you have a PPO, medical services you receive from out-of-network providers may not be covered or may be paid at a lower level.

Preferred Provider Organization (PPOs) are a popular option

PPO plans account for 22% of all individual and family plans selected by consumers shopping with eHealth, according to our Health Insurance Price Index Report.
A licensed insurance agency such as eHealth can help you identify your needs and budget, then choose from a broad variety of PPO plans offered by major insurance companies. To help find the right health plan for you, enter your zip code where requested on this page to see a quote.

Related articles

We’ll let you know when we publish anything new.