PPO plans let you see any provider, with lower cost-sharing if they're in-network. No referrals required for specialists. Premiums are higher than HMO, but flexibility is unmatched.
Typical cost
$420-$780/month for a single 40-year-old on a Silver PPO.
How PPO plans work
- 01
No PCP requirement.
- 02
See any provider - in-network providers cost less.
- 03
Out-of-network care covered at a higher cost-share.
- 04
Higher premiums, higher deductible than HMO.
Pros
- • No referrals needed
- • Out-of-network coverage
- • Larger provider universe
Cons
- • Higher premiums
- • Higher cost-sharing on out-of-network care
- • Easy to inadvertently visit non-network providers
Best for
- Travelers
- Families with specialists outside one network
- Buyers who value flexibility over price