In a PPO, what are subscribers allowed to do regarding their choice of physicians?

In a Preferred Provider Organization (PPO), subscribers have the flexibility to choose their healthcare providers without the requirement to stick exclusively to in-network physicians. This means that they can receive health care services from any provider, whether in-network or out-of-network. While using in-network providers typically results in higher cost savings such as lower copayments and coinsurance, subscribers also have the option to see out-of-network providers, albeit at a higher out-of-pocket expense.

This structure is one of the defining characteristics of PPOs, as they aim to provide their members with a greater degree of choice and access to a broader network of healthcare professionals. Consequently, the ability to visit contracted and non-contracted providers without any requirement to choose only in-network options is a key aspect of how PPOs operate.

In contrast to other managed care models, subscribers in a PPO do not need a referral to see a specialist, which further empowers them to make their own choices regarding their healthcare. This level of autonomy is a major advantage for individuals who value having more control over their healthcare decisions.