Preferred Provider Organization


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Related to Preferred Provider Organization: health maintenance organization

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 ?
PPO: or preferred provider organization, is one type of managed care insurance that contracts with doctors and other specialists to provide services at a discounted rate.
Plan type Indemnity plan (group medical insurance.........................72% Preferred provider organization......................48% Health maintenance organization......................27% Point-of-service organization......5% Plan features Prescription drug plan............45% Wellness program...................8% Weight-loss program................2% Other health care plan features mentioned by survey participants are self-funding, partner physicals and a wellness newsletter; 48% had flexible benefit's plans.
Annual costs for ordinary health maintenance organization plans, preferred provider organization plans and point-of-service plans range from $4,000 to $4,400 for single employees and from $11,100 to $11,800 for families.
The company pays 80% of health care benefits for employees and their dependents via a preferred provider organization (PPO).
For the first time a majority of the workers in the surveyed companies (55%) were enrolled in a managed-care health plan, defined as a health maintenance organization (HMO), preferred provider organization (PPO) or point-of-service (POS) plan.
Recently, Principal Financial announced the deal with Aetna Signature Administrators, a unit of Aetna, which the companies said would allow current and new self-funded customers access to a bundled offering of Aetna's national preferred provider organization network and stop-loss insurance.
Disser is chairman of Spectrum Vision Systems Inc., Overland Park, Kan., a managed care vision care organization and preferred provider organization. He can be reached at pjdisser@preferredvisioncare.com.
The plans include four provider-sponsored networks, one preferred provider organization, and a "triple option" hybrid plan.
The Independent Practice Association (IPA), Physician Organization (PO), Preferred Provider Organization (PPO), Groups Without Walls (GWW), group practice formation, etc.
Coverage that offers a preferred provider organization (PPO) plan combines fee-for-service plans' freedom of choice with HMO networks' managed-care incentives.
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