What are PPOs?

"PPO" stands for "preferred provider organization" and is a type of healthcare plan. The PPO consists of hospitals, doctors, and other medical services providers who join with an insurance provider and agree to provide lower-cost, but same quality, service to customers of the insurance company.

With PPOs, patients pay doctors a certain fee, called a "co-pay," which is lower than what the patient would have to pay than if she did not have the health insurance. Then, the insurance company reimburses the medical service provider the remainder of the fees for the medical service.

Like most things, PPOs have both advantages and disadvantages. Some of the advantages are that PPO patients have a large quantity of medical service providers. Moreover, PPO patients only have to pay very limited costs out of their pocket directly to the medical service provider. For example, is a PPO patient chooses to go visit a general physician, the patient might have a co-pay of $40. If the patient did not have a PPO plan, then he would have had to pay $100.

The disadvantages of a PPO are varied as well. One disadvantage is that PPOs don't help much with non-PPO medical service providers. Also, patients with a PPO plan have to go through more paperwork and bureaucracy. Furthermore, PPO patients usually have larger co-pay amounts than patients of other types of health insurance plans, such as HMOs.

Find Out More about Texas Health Insurance

If you need help deciding which insurance plan and health care options are right for you, contact the Texas health insurance company, Option 1 Health Insurance, to help you move forward.