Healthcare Acronyms

Preferred Provider Organization

The most flexible managed health care plans. Members are not required to stay in-network for health care and do not have to use PCPs. The insurance benefits are not as high as HMOs because members will have to pay deductibles and co-payments when visiting network doctors. They can go out of network for care and still receive insurance coverage, however, it will be less than what they would have received for staying in-network. Members can be responsible for up to 40 percent of their medical bills out-of-pocket by going out of network. See also EPO, HMO, and POS.