What is a PPO Health Insurance Plan?

PPO means “Preferred Provider Organization” plans. They are one of the most popular types of health plans in the Individual and Family market. PPO plans allow you to visit whatever in-network physician or healthcare provider you wish without first requiring a referral from a physician.

Is a PPO Plan right for you?

A PPO Plan will give you and your family more flexibility and freedom to choose almost any healthcare facility or provider for your medical needs. Unlike an HMO plan, you will not be required to get a physician referral prior to seeing a specialist. And some PPO plans will cover a portion of your out-of-network claims. Often, PPO plans may include higher premiums and higher co-payments than HMO plans, given the added level of flexibility offered.

PPO plans will also have an annual deductible to pay before the insurance company starts covering your medical bills. You may also have a co-payment for certain services or be required to cover a certain percentage of the total charges for your medical bills.


PPO (Preferred Provider Organization) Plans Accepted By Hoag

  • Aetna Open Choice
  • Anthem Blue Cross
  • Beech Street*
  • Blue Cross Standard
  • Blue Shield
  • CA Foundation for Medicare Care
  • Choice Care (Humana)
  • CIGNA
  • First Health/Coventry Health*
  • Great-West Healthcare
  • Humana Choice Care
  • Interplan/HealthSmart*
  • MultiPlan*
  • Orange County PPO (OCPPO)
  • PacifiCare/United
  • Private Healthcare Systems (PHCS)*
  • Prudent Buyer (Blue Cross)
  • Shield Select (Blue Shield)
  • United Healthcare

POS (Point of Service) Plans Accepted By Hoag

  • Aetna Managed Choice
  • Aetna Managed Choice II
  • Blue Cross Plus
  • Blue Shield
  • CIGNA
  • CIGNA Open Access Plus
  • Great-West Healthcare
  • PacifiCare Choice
  • United Healthcare

EPO (Exclusive Provider Organization) Plans Accepted By Hoag

  • Aetna Elect Choice
  • CA Foundation for Medical care
  • Oscar
  • PacifiCare EPO, Varies by Employer Group
  • Private Healthcare Systems*​

What do I need to do during Open Enrollment if I select PPO Plan?

You will need to select the PPO plan network that works best for you and your family. It is a good idea to review each insurance plan’s network of preferred doctors to help minimize your out-of-network expenses. Unlike an HMO plan, you will not need to choose a primary care physician when selecting a PPO plan.

Regardless of which PPO insurance plan you select, the in-network healthcare services will be covered at a higher benefit level than the out-of-network services. Therefore, it is important to check with key specialists you currently work with to ensure you will have the highest level of benefit coverage.