Preferred Provider Organization

(redirected from Prudent buyer)
Also found in: Dictionary, Medical, Legal.

Preferred Provider Organization

A health insurance plan in which the policyholder receives a discount from the full price if he/she receives medical services from a participating doctor, hospital, or other medical organization. In many ways, a PPO operates like other insurance policies: the policyholder pays a premium each month and, in exchange, the insurance company pays for the cost of medical care, after a deductible and co-insurance. What distinguishes a PPO from other policies is the fact that a group of doctors or hospitals may negotiate a discounted rate with the insurance company. This provides the policyholder with an incentive to receive care from this group. However, medicals services provided by organizations outside the group are also covered. See also: Health maintenance organization.

Preferred Provider Organization (PPO).

A preferred provider organization (PPO) is a network of doctors and other healthcare providers that offers discounted care to members of a sponsoring organization, usually an employer or union.

You may also arrange private insurance coverage through a PPO.

If you're insured through a PPO, you make a copayment for each visit to a healthcare provider, though certain diagnostic tests may not require copayment.

You typically have the option to go to a doctor or other provider outside the network, but you pay a larger percentage of the cost, called coinsurance, than if you used a network doctor.

References in periodicals archive ?
CoreSource, one of the nation's leading third party employee benefit administrators, has reached an agreement with BC Life & Health Insurance Company (BC Life & Health), an affiliate of Blue Cross of California, to offer CoreSource self-funded clients domiciled in California access to the BC Life & Health Prudent Buyer PPO Plan, starting Jan.
The BC Life and Health (BCLH) plan will be known as the Prudent Buyer HCO.
The new contract takes effect April 16, 2001, and will allow Blue Cross Prudent Buyer and CaliforniaCare members to continue to access all Adventist Health's California hospital medical services without interruption.
Things are a little quiet due to the current economy but a prudent buyer will recognize that this valuable business is Opportunity Knocking.
The new rates will take effect April 16, 2001, and will allow Blue Cross Prudent Buyer and CaliforniaCare members to continue to access the hospital's medical services without interruption.
Ford noted that the multiyear agreement applies to Blue Cross of California's Prudent Buyer PPO, Blue Cross HMO and Blue Cross Senior Secure members.
The new contract is applicable to all Blue Cross HMO members, Prudent Buyer PPO members, Medicare SeniorSecure and Medicare supplemental covered lives.
Brown noted that the multi-year agreement applies to Blue Cross of California's Prudent Buyer PPO, CaliforniaCare HMO and Medicare secondary and Medicare supplement members.
The new contract will take effect May 1, 2000 and will allow Blue Cross Prudent Buyer and CaliforniaCare members to access three local Cottage hospitals as participating providers.
The plan will function as a Health Maintenance Organization (HMO) in counties where a Blue Cross Medi-Cal program has already been established, and an Exclusive Provider Organization (EPO) plan, using Blue Cross' extensive Prudent Buyer Preferred Provider Organization (PPO) network in other counties.
employees will be offered coverage through a variety of products including CaliforniaCare HMO, Blue Cross Plus, a point-of-service product that combines advantages of both the HMO and Prudent Buyer Plan PPO, as well as WellPoint Pharmacy benefits, effective Jan.
has introduced Prudent Buyer Exclusive, a new product that combines the low cost benefits of a Health Maintenance Organization (HMO) with the freedom to choose physicians and specialists within the Exclusive network without a referral.