When an employee who is covered by a PPO uses a doctor who is not affiliated with the PPO, the cost sharing provisions are the same as for the regular insurance plan offered by the employer.

Question

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A PPO (Preferred Provider Organization) is a type of health insurance plan that offers lower costs for using doctors and hospitals that are in the plan's network. If an employee uses a doctor who is not in the network, they will typically have to pay more for the services. However, the cost sharing provisions for using an out-of-network doctor under a PPO are typically the same as for the regular insurance plan offered by the employer.

When an Employee Who Is Covered by a PPO Uses