How a PPO Plan Works

A PPO is a medical plan that lets you choose, each time you need care, between in-network providers who offer their services at discounted rates and out-of-network providers. You may see any licensed in- or out-of-network provider; however, it costs you less if you see an in-network provider. You may seek services from a specialist without a referral from a primary care physician.

With a PPO plan, you are responsible for paying a certain amount of covered expenses (deductible) before the plan pays benefits. The plan pays a higher level of benefits (you pay less) when you use physicians and hospitals that have contracted with the PPO. All expenses above reasonable and customary rates are your responsibility.

If you need a Provider Directory, visit the plan web site (by clicking on the plan name in the list above, attend a Benefits Fair, or contact your Department Representative.