Which healthcare plan allows you to go to providers outside of your network, though at a higher cost?

A Preferred Provider Organization (PPO) is designed to offer flexibility in choosing healthcare providers. With a PPO plan, members have the option to see any doctor or specialist, even those outside of the network. However, utilizing out-of-network providers typically incurs higher out-of-pocket costs compared to in-network providers. This structure encourages patients to visit network providers for lower costs while still allowing the freedom to access other providers when necessary.

In contrast, Health Maintenance Organizations (HMOs) require members to choose a primary care physician and obtain referrals to see specialists, generally limiting them to in-network providers, which restricts their flexibility. Point of Service (POS) plans incorporate features of both HMOs and PPOs, permitting some out-of-network care but usually necessitating referrals and offering lower costs for in-network services. Exclusive Provider Organizations (EPOs) usually do not cover any out-of-network care except in emergencies, reinforcing the need to stay within the network for services.