HMO vs PPO Health Insurance
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When you shop for health insurance, you’ll see all sorts of acronyms. HMO, PPO – what’s the difference? Comparing HMO vs PPO health insurance can help you determine which plan is right for your healthcare needs.
A Health Maintenance Organization (HMO) plan provides you with health care coverage through a network of providers. HMO plans require you to select a primary care physician, and that physician must provide a referral for most specialized services. If you need care, such as emergency care, out of network, then the costs for that care will be higher.
While HMO plans limit your care to providers within their network, they tend to be more affordable than other types of health insurance plans. Premiums tend to be low, but accessing a specialist outside of the network can be difficult and expensive.
A Preferred Provider Organization (PPO) plan not only provides coverage for health services within a network of providers, but also gives you the flexibility to seek care from out-of-network providers. You’ll pay lower rates when you use an in-network provider, but you can still see out-of-network providers; you’ll just pay higher rates for the care.
PPO insurance doesn’t require you to designate a primary care physician, plus referrals for specialized services aren’t required, either. A PPO plan tends to be a more flexible option, but you’ll pay more in premiums, deductibles, and out-of-pocket costs than you will for some other types of health insurance plans.
HMO and PPO health insurance plans help make your healthcare affordable, but they do so in different ways. A HMO plan requires you to seek care from within the provider network. You’ll also need a primary care physician, and your primary care will have to refer you to specialists.
A PPO plan is more flexible. While you’ll pay the lowest costs for in-network care, you can seek care from outside the network if you choose. There’s no requirement to select a primary care physician, and there are no referrals required if you need to see a specialist.
There’s also a difference in the cost of the plans. While not as flexible as a PPO, an HMO will usually be the more affordable plan, with lower premiums. PPO health insurance gives you more flexibility, but that comes at a cost. Expect to pay more for your premiums, deductibles, and out-of-pocket expenses, especially if you seek out-of-network care.
Whether you know which type of plan is best for you or you want to get an idea of pricing, comparing quotes can help you find the best, most affordable health insurance plan. You can get free health insurance quotes online today to see what you’ll pay for each type of plan. From there, you can determine which plan is the right fit for your budget and your care needs.
Paige Cerulli Paige Cerulli is a freelance content writer and journalist who specializes in personal finance topics. She graduated from Westfield State University and brings more than a decade of professional writing experience to the ConsumerCoverage team. Paige’s work has appeared in outlets including USA Today, Business Insider, and more.
