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The Difference Between HMO and PPO

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When choosing health insurance, you may have the option to pick the network of care providers that you like best or that fits your particular situation.
The two networks are HMO and PPO.
HMO stands for health maintenance organizations and PPO for preferred provider organizations.
There are significant differences between the two networks that can determine which is the right one for you.
HMOs The most important aspect of an HMO plan is that you must choose a primary care physician that is in the network to be covered.
That physician should take care of most of your medical needs and must give you a referral to see a specialist.
The specialist must also be in the HMO network to be covered.
If you have an HMO plan and see a physician outside of the network, you will not be covered.
The exception is a situation in which you are injured away from home and have no choice but to see a non-HMO physician.
HMO plans do not require you to meet any deductibles.
There are small co-pays, as with any insurance plan, but the lack of deductible is a great benefit of HMO plans.
PPOs In contrast to HMO plans, with PPOs you are not limited to the physicians within the network to be covered.
If you would like to choose a PPO physician as your primary care provider and later decide to go see a specialist who is an HMO physician, there would be no problems.
Additionally, you wouldn't need a referral to receive the care from the specialist.
There are however financial incentives to stay within the network.
If you receive care from a PPO-physician, you will most likely have a greater percentage of the total cost paid for by the insurance than you would if you went to a non-network physician.
There are deductibles for PPO plans.
Deductibles commonly need to be met with situations such as hospital visits.
There are also co-pays for PPO plans, which are usually larger than the co-pays for HMO plans.
Look at Your Options Before Making a Choice If you are going to be choosing a new health care plan soon, it is important to understand the difference between HMO and PPO plans.
There are a number of health care options out there to choose from, so you should look into what is available for you and what you can afford.
To get more information on health care options, visit the Option 1 website today.
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