The definition of Preferred Provider Organization PPO, and how it fits into the Zenefits Health Insurance Marketplace

What is a PPO?

A Preferred Provider Organization (PPO) plan is a type of medical insurance plan with nationwide coverage and no requirement for a Primary Care Physician.

 

How does a PPO work?

PPO plans are often big carriers with a wide network that offer nationwide coverage. PPO plans offer in-network and out-of-network coverage.  Services by in-network providers will have a higher benefit and less out-of-pocket cost to enrollees than out-of-network providers.

Enrollees can see any doctor any time with a PPO plan and a referral from a Primary Care Physician (PCP) is not necessary.