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Can someone explain a ppo vs. an hmo... from what i understand, it appears that an hmo is less expensive?


Can someone explain a ppo vs. an hmo... from what i understand, it appears that an hmo is less expensive?

I believe you are right... HMOs are less expensive, but you have to pick from the doctor list you are given. I think there are also referrals involved which makes seeing other doctors a tedious process. In general, I think they are less flexible, but I could be wrong.

HMO are cheaper, generally, because they lock you in to a Health Maintenance Organization... meaning, they chose the doctors, medicines, treatment options, locations,etc...
PPOs generally give you more control over these things... and since there is more choice (read- less control over costs) it costs more. Generally not much more, but I realize sometimes the difference can make a noticeable difference in a paycheck. Weigh your options, and health care needs. do you have a doctor you like? or a doctor office is close by? these things will likely change with an HMO.

in a hmo they tell you where you can go and you have to have referrals for any medical doctor specialist that you see and in a ppo you do not have to have that referal...i have appo and they are not as intrusive as the hmo is...but the referal is the big difference as far as cost goes I am not sure because my husbands plan is paid for by the company he works for....

yeah like justr said.

PPOs *in general* tend to be a little better, and HMOs *in general* are cheaper and not quite as good (theyre more controlling and tell you what doctors/hospitals you can go to, what procedures they will pay for, etc. where PPOs tend to have a large network of doctors and medical facilities and will pay for a wider variety of procedures). but those are stereotypes, there are good HMO plans and bad PPO plans. the lines can somewhat blur.

HMO's are an insurance company plan that requires you to pick for an established list. You have to see a primary care physician, and if needed, they will then refer you to a specialist.

HMO's are less expensive than a PPO.

PPO will let you see anyone you want, specialist or not. However you will pay a bigger premium for the PPO.

HMO doctors, on average, are not as good as PPO doctors. The reasoning behind this is HMO practices are fed a stream of patients via their network, so they do not have to be as good at their job as a PPO doctor and still have a full patient load.

HMO's are less expensive on your part, but the tell you the one (or few doctors or hospitals or clinics) that they will cover with Health insurance if you go for medical attention... They have strict rules about it....Be sure to see how far you will have to travel to get to the places they will pay for, and how full their schedules are, in case you need to go, will there be weeks long waiting period to get in, or can you get an appointment pretty quickly?
PPO's offer the freedom to go pretty much where you want to go to the doctor. If you have a favorite doctor, you may want to check into it. PPO's often cost more per monthly premium, but where I live, it's worth it.
Check what other people like, who work with you, to see what they use and like, if you want good advice.

Yes, HMO plans are generally less expensive. However, the the HMO Plan you are restricted to only seeing doctors who are part of the HMO network, which is often far more limited than PPO networks. In addition, a gatekeeper, or doctor must always approve you going to any kind of specialist.

Usually, with PPO you can go any doctor in your network, which offers more doctors, and any doctor outside of your network can be seen for an increased co-pay. PPO, is usually more expensive but offers the greatest amount of flexibility. The best way to compare plans, is going to a broker site like ours, and get quotes. Feel free to check us out: www.viewhealthinsurance.com

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