PPO.

A PPO is a health plan that lets you see any doctor without a referral and still covers out-of-network care, though it costs more.

Reviewed by Joseph Citizen, Founder · Last reviewed June 11, 2026

Verified June 2026 · Source: HealthCare.gov

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PPO

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In plain English

A PPO (Preferred Provider Organization) is a health insurance plan that gives you more freedom than most other plan types. You can see specialists without a referral, and the plan still pays a share of the bill even when you go outside its network, just at a lower rate. In exchange for that flexibility, PPO premiums and deductibles are usually higher. Staying in-network still saves you money, but the door to out-of-network care stays open.

Most useful ages

18 to 64

01Why it matters

If you want to keep a specific specialist or you travel a lot, a PPO protects you from getting nothing back when you go out-of-network, but you pay for that freedom every month.

02The math, step by step

You have a PPO and want to see a dermatologist. You book the appointment directly, no referral needed. If the dermatologist is in-network, you pay your normal share. If they are out-of-network, the plan still pays part of the bill, but you cover a bigger slice and may also face balance billing on the difference.

03What this is NOT

Do not confuse with An HMO

A PPO is not an HMO. An HMO restricts you to its network and usually requires referrals. A PPO lets you skip referrals and still pays something toward out-of-network care.