PPN stands for Preferred Provider Network. It is the network of hospitals that have deeper tie-ups with respective health group insurance companies to provide seamless and cashless claim services to their policyholders. A hospital joins PPN when both the hospital and insurance company synchronize in their approach on how to serve the policyholders. Therefore, the hospital and insurance companies sign up for an agreement regarding service levels, treatment costs, and discounts on incidental costs incl. pharmacy and pathology, payment terms, patient volume, etc. to firm a long-term partnership. So, let’s get to know how does PPN network policies work.
Key Takeaways
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Pre-Negotiated Pricing: PPN hospitals agree to standardized “package rates” for common surgeries. This ensures that your sum insured is utilized efficiently and you aren’t overcharged for routine procedures like appendicitis or cataracts.
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The Premium-Savings Link: Because the insurance company saves money through PPN discounts and volume-based agreements, they pass those savings on to you in the form of lower annual premiums.
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Cashless Ecosystem: A PPN is more than just a list of hospitals; it is a long-term partnership involving synchronized payment terms. This makes the cashless approval process faster and more reliable compared to non-network facilities.
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Geographical Strategy: Before choosing a PPN-only plan, it is vital to check if your preferred local hospitals are on that specific list. For example, Public Sector insurers (OIC, UIIC) have extensive PPNs in Tier-2 and Tier-3 cities.
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Incidentals and Pharmacy: PPN agreements often include discounts on “non-medical” or incidental costs like lab tests and medicines, which can significantly reduce the final bill amount that falls under your co-payment or deductible.
PPN health insurance policy provides access to a wide network of healthcare providers, discounted rates for services, coordinated care, and potential cost savings. However, it offers limited choice of providers outside the network, potential out-of-network expenses, and restrictions on certain treatments or specialists not available within the network.
It is common for insurers to provide options to policyholders to choose between policies that cover claims in –
- Open network – Open hospital network policies in health insurance allow policyholders to receive medical services from a wide network of hospitals and healthcare providers, offering greater flexibility and access to healthcare facilities within the insurance coverage.
- PPN network only – PPN stands for Preferred Provider Network policies in health insurance, which offer discounted rates and benefits when receiving healthcare services from network providers.
To reiterate, PPN network policies are cost-effective compared to Open network policies as insurers are able to translate the savings from claims to policy premiums.
Summary: PPN Network vs. Open Network
Below are a few insurers that offer policies with PPN network –
- All Public Sector Insurers (NIA, NIC, UIIC & OIC)
- ICICI Lombard GIC
- Religare Health – Now Care Health
- Reliance GIC
Frequently Asked Questions (FAQs)
Q1: What happens if I am admitted to a hospital that is NOT in the PPN?
A) If you have a “PPN Network Only” policy, your claim might be rejected or you may have to pay a significant portion of the bill out of your own pocket as a penalty. Always verify the hospital list before planned admissions.
Q2: Are “Network Hospitals” and “PPN Hospitals” the same thing?
A) Not exactly. While all PPN hospitals are part of the network, a PPN is a deeper tier of partnership. PPN hospitals have agreed to specific, capped pricing for surgeries, whereas regular network hospitals might only offer basic cashless services without fixed package rates.
Q3: Can a hospital be removed from the PPN list during my policy term?
A) Yes. PPN lists are dynamic and updated based on ongoing service agreements. In 2026, it is highly recommended to check the insurer’s live app or website 24 hours before a planned surgery to confirm the hospital is still “Preferred.”
Q4: Is the PPN list the same for all insurance companies?
A) No. Every insurer (like ICICI Lombard vs. New India Assurance) negotiates its own PPN agreements. A hospital might be a “Preferred Provider” for one insurer but only a “Regular Network” hospital for another.
Q5: Why do Public Sector insurers (like LIC or NIC) favor PPN policies?
A) Public sector insurers manage very high volumes of claims. By using a PPN, they can standardize costs across India, reducing fraud and ensuring that taxpayer-supported funds are used responsibly to cover as many policyholders as possible.
About The Author
Mayank Sharma
MBA Finance
He is a professional who brings extensive knowledge and expertise to the field of group health insurance. He has dedicated 7years to helping individuals and businesses navigate the complexities of insurance. Having worked closely with numerous clients and insurance providers, he deeply understands the nuances of group health insurance policies. With a reputation for providing insightful and informative content, he leverages his industry experience to educate readers about the importance of group health insurance and its benefits. Through their articles, Mayank Sharma aims to empower individuals and businesses to make informed decisions about their healthcare coverage, ultimately promoting healthier and more secure communities.
