The difference between PPO and HMO plans

The difference between PPO and HMO plans

Healthcare can be a super intimidating topic for a lot of people. Not only do a lot of people not know what all of their options are, but most individuals aren’t even sure what type of coverage they need. Some may only be looking for themselves, others will be looking for their family or small business. Regardless of what exactly you are looking for, you should be aware of all of your options. 

When looking into health insurance, you will be hit with a lot of terms and abbreviations that you won’t likely know what they mean. You may hear things like a PPO or HMO plan. If you aren’t sure what that means, you may not know where to go next. Here is what you need to know about PPO plans and if they are right for you. 

What is a PPO plan?

A PPO plan stands for Preferred Provider Organization. This type of insurance plan will provide you with a bit more flexibility when you have to choose a healthcare provider or medical center location. They will give you a network of providers, but it will provide very few restrictions when it comes to visiting providers who are not within your network. In fact, PPO insurance will even pay if you see a non-network provider, though it may be less than if you visited one within your network. 

With this type of plan, your premiums will tend to be higher. You will also probably have a deductible. The main benefit of this type of insurance plan is the ability to have the flexibility and not be so restricted on what doctors you see and what medical facilities you go to. 

What is an HMO plan?

HMO stands for Health Maintenance Organization and it will provide you with access to certain doctors and hospitals within your network. This network is composed of providers that have agreed to lower rates for those within their plan. This plan is fairly strict, meaning that it will only provide coverage if the provider you saw is covered under their network. There is not much flexibility with this type of insurance plan. 

With this type of insurance plan, premiums are typically lower and you may not have to pay a deductible at all. You may be required to choose a primary care physician and get a recommendation from them to get treatments from specialists for those outside of your network to be covered at all.

What to choose

If you are someone who would prefer that your care is coordinated through one single provider, then an HMO plan may be the best health insurance option for you. If you are someone who sees a lot of specialists and you will need some flexibility within your plan to continue doing so, then a PPO plan may be the best health insurance option for you. 

Choosing health care can be scary and overwhelming for many people, especially if you aren’t sure what you are looking for. If you need help figuring out you or your family’s coverage needs, contact us at Health Server Solutions today! We can help you customize a plan that works for all of your needs and will be the best health insurance option you can find!