What is PPO?

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For people who want more flexibility and choice from their health care plan, our PPO plans are a great option. Our PPO plans offer the same reliable coverage you expect from Blue Cross Blue Shield of Massachusetts, but without the need for referrals and more choice in doctors and hospitals .

You'll get the best benefits if you choose providers in the nationwide network , however you can also choose to see providers outside the network for care.

Our PPO plans differ in cost and benefits, but no matter what plan you choose, it will have these features:

  • You are not required to select a primary care provider (PCP) .
  • You don't need referrals from your PCP to see specialists
  • Your care is covered when doctors and hospitals are in your plan network

Generally, our PPO plans cover these types of care:

  • Inpatient and outpatient medical care
  • Mental health/substance use
  • Prescription drug benefits
  • Preventive care with no out-of-pocket costs

To get the specifics of your plan, check your subscriber certificate or visit MyBlue and click on the Using My Plan tab. Your member ID card contains valuable information so it's important for you to know how to read your ID card. Watch our Managed Care video to learn more about your health plan.