Heath Insurance | HMO's vs. PPO's
It is vital that you know the difference between HMO and PPO plans before you decide which coverage to choose. While cost is obviously most important, it is not the only factor or difference between the health insurance plans. You should carefully review all of your options, then choose the plan that is best suited for you and your family.HMOs (Health Maintenance Organization)
HMO is an organization of healthcare providers (e.g. doctors and hospitals) that have contracted with an insurance company to offer their services at a fixed price.HMO Disadvantages
HMO plans generally have many rules and a structure that you need to adhere to . A primary care physician is chosen, and they handle all aspects of your healthcare. In addition, the physician you select must be an active member of the HMO network. If the doctor you typically use is not a member of the HMO, you will have to absorb the full cost if you continue to utilize their services. If you need to see a specialist, you must go through your physician, who in turn needs to grant a referral to move forward under the HMO structure.
HMO Advantages
HMO's generally appeal to people who are more concerned with cost above all else. Your health insurance premiums are much cheaper, and your visits to the doctor will only entail a very small fee. A major advantage is if your physician is a member of the HMO!PPOs (Preferred Provider Organization)
While PPO physicians have a relationship with the insurance company, they are loosely organized and have many more options than a HMO plan.PPO Advantages
Under a PPO, you can visit whichever doctor you want, however if the physician is not in the network, you will incur a greater out of pocket cost.. A huge benefit for PPO plans is that you do not have to go through any type of gatekeeper or primary care physician to see a specialist. This typically saves quite a bit of time, and opens up your options.Even though a PPO is usually costlier than a HMOs, many insureds tend to select them as they are less restrictive and you ultimately have control over all of your healthcare decisions.
HMO or PPO? Which is the Better Option?
HMO individual or family health care plans cover preventive care and emegencies, and also provide long term protection for you and your family. A HMO also provides low deductibles, prescription drugs benefit, and co-pays on doctors.Compared to HMO, PPO plans are a little more expensive, but it is still a more affordable option compared to fee for service plan. You can choose to lower monthly premiums by raising your deductibles.
Often, your decision will be based on your financial situation. HMOs are significantly cheaper, and is more sensitive for the amount that you have to pay out-of-pocket. PPOs give your more flexibility and control.
After reviewing the difference between HMO and PPO health insurance plans, you can now make an educated decision between the 2 plans. It all comes down to a cost vs. flexibility decision, and armed with knowledge, you can make the call.
For more HMO, PPO, and Health insurance questions, please contact one of our HMO and PPO advisors in our agent section.
