What is a preferred provider organization (PPO)?

A preferred provider organization (PPO) is a type of health insurance plan available in North Carolina. The PPO allows individuals to choose from a network of doctors, hospitals, and other health care providers that have agreed to provide services at a discounted rate. These preferred providers have pre-negotiated fees with the insurer in order to make their services more affordable for the insured. PPO plans are usually more expensive than traditional indemnity plans but have the advantage of allowing members to receive services from any of the providers in the network without needing a referral from a primary care physician. These plans also typically include some coverage for out-of-network care, although members usually have to pay a higher amount when seeing providers outside of the network. Members of a PPO plan must generally follow certain rules regarding pre-authorization for certain services, which means that members must get approval for certain procedures or treatments before they are covered by the insurance. This helps to ensure that the procedures and treatments are medically necessary and helps to keep costs down. PPO plans are a popular choice in North Carolina and are a go-to for many individuals and businesses looking for health coverage. Aware of the benefits of the PPO plan, employers and individuals are encouraged to review PPO plans and find one that best fits their needs.

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What is a preferred provider organization (PPO)?

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