In the United States, 44 million people don’t have health insurance.
If you are shopping for health insurance, you have noticed there are a lot of options out there. One of the most important decisions is to pick between an HMO and a PPO plan.
In this article, we will break down the difference between HMO vs PPO. Read on to get started.
PPO Insurance Plans
Preferred Provider Organization or PPO differ from HMO because they offer more flexibility when it comes to choosing a doctor or hospital. Although PPO plans still have a preferred network of doctors, they offer more flexibility if you want to see a doctor that is out of network.
If you choose to see an out of network doctor, a PPO plan will cover but at a lower rate.
With PPO plans, you can still schedule a consultation with a specialist without having a PCP. If the circumstances require you to see a doctor out of network, you will be able to do so with a PPO plan.
PPO plans also have a higher deductible and premium.
HMO Insurance Plans
With a Health Maintenance Organization or HMO plan you can choose from doctors and hospitals in your network. Because the network has a contract to offer lower rates for plan members, you must adhere to network providers.
While PPO plans will still cover you if you see an out of network provider, HMO plans require you to stay within the network.
HMO plans also have more restrictions when it comes to the number of tests, treatments, and visits.
Also, if you have an HMO plan, you will have to select a primary care physician (PCP) for all of your visits. An HMO plan will only cover your visits to a specialist with an order from your PCP.
Many people choose an HMO plan because the premiums are lower than PPO plans, and they often don’t have a deductible.
HMO vs PPO
When choosing a healthcare plan, you need to take into consideration the network, PCO, and overall costs.
Networks
When choosing a plan, you need to take the network into consideration. You need to stay within your network to get lower costs.
While networks vary from insurance carrier to carrier, PPO plans have a broader network.
Primary Care Physicians
If you choose an HMO plan, you will have to get a PCP for all of your health needs. A PPO plan doesn’t require you to have a PCP, and you can visit any doctor within your network.
Costs
If cost is a big concern when choosing a health plan, keep in mind that PPO plans are more expensive than HMO plans. Although HMOs have more restrictions, they have lower premiums and no deductibles.
PPO plans have higher premiums and deductibles, but they offer more flexibility.
Chose the Right Healthcare Plan to Fit Your Needs
Now that you know the difference between HMO vs PPO, its time you choose the right plan for you. HMO plans tend to have lower premiums and deductibles, and PPO plans have higher deductibles.
PPO plans have a larger network and don’t require you to get a primary care physician. HMO plans require you to stay within the network, and you need a PCP.
Are you ready to get the coverage you need? Contact us today.