Which of the following describes a PPO plan?
Asked by: Prof. Lucy Ratke | Last update: January 1, 2026Score: 4.4/5 (31 votes)
What does PPO mean for a plan?
Preferred provider organization (PPO) A type of medical plan in which coverage is provided to participants through a network of selected health care providers, such as hospitals and physicians.
What is a PPO plan quizlet?
PPO (Preferred Provider Organization) Managed care organizations structured as a network of healthcare providers who agree to perform services for plan members at a discounted fees. usually, PPO plan members can receive services from non-network providers for. a higher charge.
Which statement is true of PPO plans?
A Preferred Provider Organization (PPO) is a type of health insurance plan that contracts with medical providers to offer discounted rates to insured individuals. One of the true statements about a PPO is that its goal is to channel patients to providers that discount services, which is option 1).
Which of the following is true of a PPO?
Final answer: The true statement about PPOs is that they aim to direct patients to healthcare providers offering discounted services. PPOs have higher premiums and include cost-sharing measures such as deductibles and copayments.
What is a PPO Plan? | WPS Explains
Which of the following describes a PPO?
A type of health plan that contracts with medical providers, such as hospitals and doctors, to create a network of participating providers. You pay less if you use providers that belong to the plan's network.
What does a PPO consist of?
A preferred provider organization (PPO) is a health insurance plan for individuals and families. PPOs involve networks made up of contracted healthcare providers, including doctors, hospitals, and other medical professionals.
What is true regarding a PPO?
Unlike an HMO , a PPO offers you the freedom to receive care from any provider—in or out of your network. This means you can see any doctor or specialist, or use any hospital. In addition, PPO plans do not require you to choose a primary care physician (PCP) and do not require referrals.
Which of the following is true about a PPO Quizlet?
Which of the following is true about a PPO? The insured person does not need to choose a primary care physician to coordinate care.
Which of the following is not a true statement about PPOs?
Final answer: The statement that is not true about PPOs is that the copay is usually lower for an office visit than with an HMO. In reality, PPOs often have higher copays. Other statements about PPOs regarding prescription reimbursement and deductibles are accurate.
What is PPO used for?
The PPO provides an incentive for you to get your care from its network of providers by charging you a higher deductible and higher copays and/or coinsurance when you get your care out-of-network.
Which of the following is not true about PPOs?
Final answer: A PPO (Preferred Provider Organization) is a flexible health insurance plan that allows policyholders to see any healthcare provider. It is not true that a PPO generally comes with a deductible, and patients do not have to pay a monthly premium on top of deductibles and copays.
What is a plan characteristic for patients with a PPO?
The PPO Plan summary outlines In-Network and Out-of-Network benefit coverage. This means that you can see a provider who is not on the preferred (or network) list, but you will pay more for these visits since the provider is not part of the pre-negotiated discount.
Who benefits from PPO plans?
With PPO insurance, you'll pay less out of pocket when you get care within that network. You can still see an out-of-network provider, but you'll get the most coverage when you stay within the PPO network. PPO health plans may be a good fit for someone who lives in 2 different states or travels often within the U.S.
How to know if a plan is PPO?
Your Summary and Benefits should have information about the plan near the top, detailing whether your plan is a PPO or another type of insurance. If you still cannot find the answer, give the customer service number on the back of your insurance card a call and ask if your plan is a PPO plan.
Why is a PPO plan better?
In a PPO plan, you have a network of “preferred” providers. These include doctors and specialists who can offer care at the lowest out-of-pocket cost, compared to out-of-network providers. With PPO insurance, you can also choose to see a doctor who is not in the preferred network.
Which of the following best describes a PPO plan?
Preferred Provider Organization (PPO): A type of health plan where you pay less if you use providers in the plan's network. You can use doctors, hospitals, and providers outside of the network without a referral for an additional cost.
What is true about PPO plans?
PPO insurance plans allow plan participants to choose from a larger network of doctors and hospitals without needing a referral to see a specialist. While PPO plans allow for out-of-network care, they tend to have higher monthly premium costs and annual deductibles than other types of health insurance plans.
What is a PPO quizlet?
PPO. A Preferred Provider Organization, or PPO, allows the covered individual to choose providers for medical service that are within or outside of the PPO network. Choosing a physician outside of the PPO network will cost more out-of0pocket, but coverage is existent.
Which of the following is a main characteristic of a PPO?
A PPO is a type of health plan that allows members to see providers in and out of the plan's network. While members can use providers outside the network, they will have higher out-of-pocket costs and some services may not be covered.
What are 3 disadvantages of a PPO?
- Higher monthly premium.
- Higher out of pocket expenses.
- Must monitor in-network vs out-of network to control cost.
Which of the following is an example of a managed care plan?
A good example of a managed care plan is a Health Maintenance Organization (HMO). HMOs closely manage your care. Your cost is lowest with an HMO. You are limited to seeing providers in a small local network, which also helps keep costs low.
Which of the following is a characteristic of preferred provider organizations (PPOs)?
A characteristic of Preferred Provider Organizations (PPOs) would be: Discounted fees for the patient. Under Preferred Provider Organizations, patient fees are: Discounted in return for using listed providers.
What is the usual payment arrangement under a PPO contract?
The usual payment arrangement under a Preferred Provider Organization (PPO) contract involves a combination of co-payments, deductibles, and co-insurance. After the deductible is met, the insurance company starts covering a significant portion of the costs; while the patient pays the rest.
What is a PPO dental plan?
What is a dental preferred provider organization (PPO) plan? A PPO plan is a regular indemnity plan combined with a network of dentists under contract to the insurance company to deliver specified services for discounted fees in accordance with provisions in the signed agreement.