What distinguishes a Preferred Provider Organization (PPO) from other health plans?

A Preferred Provider Organization (PPO) is characterized by its flexibility in allowing patients to see specialists without needing a referral from a primary care physician. This feature sets it apart from many other health plan types, particularly Health Maintenance Organizations (HMOs), which typically require referrals for specialist care. Individuals enrolled in a PPO can choose to see out-of-network providers, but they will generally pay higher costs compared to in-network services.

This aspect of PPO plans appeals to many consumers who value the ability to make decisions about their healthcare without additional steps such as obtaining referrals. While it is true that PPOs provide this freedom, they also typically offer broader coverage options compared to plans that limit patients to in-network providers only.

The other options do not accurately depict the defining features of PPOs:

• Limiting coverage to in-network providers is more characteristic of HMO plans.

• While PPOs may offer competitive premiums, it's not a distinguishing feature as many health plans can vary widely in terms of cost.

• A mandated minimum waiting period for services is generally a feature of specific plans rather than a broad characteristic of PPOs.

Thus, the most accurate distinguishing feature of a PPO is its lack of a referral requirement for accessing specialist care.