- In a preferred provider organization (PPO), physicians and medical facilities contract with a third-party administrator to offer discounted health insurance. Those with PPO insurance can seek treatment from providers within the network, or from those contracted with the organization, or from out-of-network providers, though higher fees are generally charged for out-of-network care. A PPO generally offers lower out-of-pocket maximums but may feature higher copays.
- In a point of service (POS) plan, participants must select a primary care physician who is the "point of service." The physician must refer patients to specialists within the network if their care is required. Like PPOs, POS plans provide some compensation for out-of-network medical care, but not as much as for in-network care.
- Compared with health maintenance organizations (HMOs), PPOs and POS plans typically offer more flexibility in seeking treatment from health care providers outside a specific network, according to the Med Health Insurance website and the PPO-Health-Insurance website. HMOs usually do not pay for medical care from an out-of-network provider, even if an in-network provider is unavailable in a particular area.
PPO Insurance
POS Insurance
Compared With HMOs
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