HMOs Verses PPOs – Understanding Your Options In Health
Choosing the right health insurance for you and your family can be a difficult
decision, and the terminology used in policies, especially in the health
insurance market, can make the options available even more complicated. If
you are considering health insurance options, understanding the difference
between HMOs and PPOs can help make the choice easier and clearer. This
article will help you understand the difference between these two popular
health insurance options and determine which is best for you.
HMOs, or Health Maintenance Organizations, are prepaid health plans that
offer comprehensive medical coverage in exchange for a monthly premium.
The care you receive is limited to healthcare providers and institutions that
have an agreement with the HMO you select, and so this limits where you
can receive healthcare and from whom, except in the case of an emergency.
These types of plans usually also include a small co-payment for most
expenses such as doctor’s visits or hospitals stays, and depending on the
type of coverage you select it may or may not include prescription drugs.
The costs associated with HMOs are usually more predictable than other
PPOs, or Preferred Provider Organizations, are more of a subscription type
healthcare option than a comprehensive medical plan. This type of coverage
gives you a discounted rate for healthcare from the specific providers
associated with your PPO, and they act as a middle man between you, the
insured, and the healthcare provider. In general these plans offer more
flexibility in coverage, as you do not need a Primary Healthcare Provider, and
you can see doctors out of network and still receive coverage, though at a
higher premium. Most PPOs have higher annual deductibles and larger copayments.
There are definitely benefits to both types of health insurance plans.
Consider your options carefully and choose what makes sense for you and