HMO and PPO Health Insurance Plans
HMO and PPO plans are two of the most common kinds of health insurance plans available. Theyıre a lot alike ı but there are some crucial differences.
Whatıs the difference? And which one is the better choice for you? Hereıs what you should know.
HMO Health Plans
If affordability is your number-one priority when youıre shopping for health insurance, an HMO plan might be your best bet.
Health Maintenance Organizations are among the cheapest health insurance plans you can find. In an HMO, an insurance company creates a network of doctors and hospitals. In return for the increased business that being a member of the network brings in, these doctors and hospitals agree to offer their services at a discount. This discount is passed on to plan members.
Important facts about HMOs:
- Most HMOs have no deductible. That means your coverage starts as soon as you start receiving care.
- HMOs require you to choose a Primary Care Physician. This physician ı usually a general practitioner, an OB/GYN, or a pediatrician ı is your first point of contact with the healthcare system. Theyıll be responsible for referring you to specialists when you need care they donıt provide.
- You need to get care within the HMO network to stay covered. One of the ways HMOs keep their costs low is by only covering services given by members of their provider network. If you see a doctor or visit a hospital outside the plan network, you wonıt get any coverage ı unless the visit qualifies as an emergency.
For most people, staying in the HMO network isnıt a problem. Many HMO plans have large networks, with plenty of doctors to choose from. For example, the Blue Cross HMO network includes over 14,000 doctors throughout California.
PPO Health Plans
If you donıt mind paying a little more to have flexibility in your healthcare, think about getting a PPO plan.
Preferred Provider Organizations also have networks of doctors and hospitals. But unlike HMOs, theyıll still give you some coverage when you go outside the plan network for care.
PPOs tend to cost more than HMO plans. For many people, the added flexibility is worth the extra money. In a PPO, youıll save more money by getting care within the network. But you can continue to see your current doctor, even if they arenıt in the network.
Things you should know about PPOs:
- In a PPO plan, youıll have to meet a deductible to get coverage. But many PPO plans have flexible deductibles, so you have some control over how much youıll spend when you get care. The higher the deductible you choose, the lower your monthly premiums.
- PPOs donıt require you to choose a primary care physician. And you wonıt need a referral to get specialist care.
- PPOs typically have larger provider networks than HMOs. You get the most savings when you stay in the plan network, and youıll have plenty of providers to choose from. In the Blue Cross PPO network, there are more than 50,000 doctors and over 400 hospitals.
Still not sure which plan type is best for you? Why not compare plans and prices and see for yourself? Get free online quotes to start comparing plans now. | 
