What Is a PPO (Preferred Provider Organization)?
A PPO covers care from providers outside its network, at higher cost sharing, and does not require a referral to see a specialist. That out-of-network coverage is the entire point: it is the plan type you choose when you need flexibility.
Best suited to: people with established specialists, those who travel frequently, and anyone who needs a specific out-of-area facility.
PPO Availability on the Colorado Marketplace (2026)
PPO availability in Colorado is decided county by county rather than statewide, and the mix of plan types offered on a state's marketplace changes year to year. Confirm what is actually available in your ZIP code's rating area before assuming a PPO is on the menu.
How to Compare PPO Plans in Colorado
- Network first, premium second. Confirm your doctors and hospital participate in the specific plan — not just the carrier. Carriers run multiple networks.
- Deductible and out-of-pocket maximum. The OOP max is your true worst case for the year.
- Drug formulary. Check your prescriptions by name and tier.
- Referral rules. PPOs do not require referrals, which is often the reason to choose one.
- Subsidy interaction. Cost-sharing reductions only attach to Silver plans, which can make Silver the better value even at a higher premium.
Frequently Asked Questions
Are PPO plans available in Colorado for 2026?
PPO availability in Colorado varies by county and changes year to year, so confirm what is offered in your ZIP code's rating area.
What is the difference between PPO and the other plan types?
PPO plans cover out-of-network care at higher cost sharing and need no referral. POS plans cover out-of-network care but usually require a referral. EPO plans require no referral but cover out-of-network care only in emergencies. HMO plans generally require both a network provider and a referral. The out-of-network benefit and the referral rule are the two variables that matter.
Does PPO cost more in Colorado?
Plan type is only one factor in price. Age, county rating area, metal tier, and tobacco use all affect the premium, and subsidies are calculated against a benchmark Silver plan regardless of the plan type you choose.
Can I switch plan types mid-year in Colorado?
Only with a qualifying life event that opens a Special Enrollment Period — losing coverage, moving, marriage, or a new baby, among others. Otherwise plan changes happen during Open Enrollment, November 1 through January 15.