The rising costs of medical care could have you wondering – “what’s the difference between PPO and HMO insurance?”
If that question sounds familiar, this is your article! We’ll explain both policy types in easy to understand terms and help you determine which might benefit you the most.
Keep reading for all the details.
What Is HMO Insurance?
HMO is short for Health Maintenance Organization. Simply put, an HMO is a group or network of doctors, hospitals, and healthcare providers who have agreed to work together and offer care at a reduced rate.
To help keep prices low, an HMO might require users to select a primary care physician or primary healthcare provider, sometimes referred to as a PCP. This doctor can then refer you to specialists as needed.
HMO plans will only cover healthcare if it’s provided by a member of their network, with the exception of emergency care, which may be covered out of network.
HMO plans are often less expensive than PPO plans, and come with lower monthly payments. Their biggest downside is that you might not get to keep the same doctor, or experienced a more limited selection of medical providers. And, if you’re out of town, you might need to wait until you are back home to handle a non-emergency medical concern.
What Is PPO Insurance?
PPO stands for Preferred Provider Organization.
This organization is a network of doctors, hospitals and healthcare providers who have agreed to provide care at a fixed rate. However, users aren’t strictly limited to providers within their plan.
Unlike an HMO, this plan lets users receive medical care from any doctor or facility, but their copay or upfront costs for out of network visits will be higher than those for network members. This also applies to medical services like lab testing, specialist visits, and addiction treatment.
This means that you don’t need to maintain a primary care physician, and are free to see any doctor you want, including specialists without a referral. This is especially helpful for frequent travellers and people who move often. And, it can come in handy if you don’t have time to wait for an appointment with your PCP.
In exchange for that added flexibility and decrease in negotiations for specialized care, PPO plans require a higher monthly payment.
PPO Vs HMO – Find Your Best Fit
Now that you know a bit about choosing between PPO vs HMO healthcare, it should be easier to understand which plan will work best for you.
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Don’t hesitate to contact us with any questions you might have about our facilities, services, and which insurance policies we accept. All communication will be kept strictly confidential, and our compassionate staff is standing by to help.
