@tsch That is the idea of any advantage plan, PPO included - to stay within a network. However, if a treatment is not available, a good plan will pay for you to go elsewhere. That is what my not-for-profit advantage plan paid for when I had my septal myectomy at Mayo. Absolutely no problems, if there were any, I was not aware them. In fact, I was charged the in-network hospital copay amount ($350) rather than the $800 stated in my benefits list for a hospital out of network. It is so sad, stressful and unnecessary that we practically need to get a PhD in insurance coverage to navigate this maze. My former employer has a particular plan for retirees.