Co-Founder, TermInsuranceBrokers.com, Goldenzweig Financial Group, Las Vegas, Nevada
It ultimately comes down to what's right for you. HMOs (Health Maintenance Organizations) and PPOs (Preferred Provider Organizations) each have their benefits and everyone has their own preferences and coverage benefit desires and premium tolerance. Cost is a big factor for just about everyone so it's important to look at what each type offers and what's available in your area.
With an HMO plan, you designate a doctor to be your primary care physician (PCP). All of your health care services are coordinated through your PCP. That means that you need a referral before you can see a specialist or other health care provider (except in an emergency). The doctors you visit must be in network - out-of-network doctors typically aren't covered.
PPO plans offer more flexibility. You're not required to designate a PCP and you can go see a specialist without a referral - inside or outside of your network. Staying inside your network means smaller copays and full coverage. If you see a physician outside of your network, you may have a higher out-of-pocket share, and not all services may be covered.
Please let me know if I can be of further assistance. Thanks very much.
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With an HMO plan, you designate a doctor to be your primary care physician (PCP). All of your health care services are coordinated through your PCP. That means that you need a referral before you can see a specialist or other health care provider (except in an emergency). The doctors you visit must be in network - out-of-network doctors typically aren't covered.
PPO plans offer more flexibility. You're not required to designate a PCP and you can go see a specialist without a referral - inside or outside of your network. Staying inside your network means smaller copays and full coverage. If you see a physician outside of your network, you may have a higher out-of-pocket share, and not all services may be covered.
Please let me know if I can be of further assistance. Thanks very much.