HMO vs PPO?

Our AETNA HMO has just switched to become an Aetna Open Access Select (meaning that you can choose any doctor without first having a referral), and also there's the PPO offering from Aetna as well. what's the difference in the 2? besides the monthly fees for both, the deductible minimums and obviously choice of doctors.

many people back away from HMOs like the plague. why?

Aetna Open Access Select is the closest you'll get to a PPO without paying for it. The major difference is that with AOAS you have to stay within network (certain list of doctors, including specialists) to obtain covered care (except for emergency & urgent care). With PPO, you can also obtain out-of-network care coverage... you'll just have to pay more.

Some people stay clear of HMO's because of the many limitations with that system. (i.e. having to go through a PCP, staying within a limited network of doctors, etc). If you are a generally healthy individual, then HMOs are great because of the lower deductibles. PPOs just provide patients with more flexibility.

Good luck!

I'm not sure what the difference is between your HMO and this open access select, however, I can tell you that I've always backed away from HMO's (after having one) because of the fact that you have to get a referral to go anywhere other than your primary doctor. It was just a hassle for me. That being said, if your new plan will allow you to go to any doctor w/out a referral now, I'd just take whichever plan is cheapest and offers the best coverage. Good luck!

PPOs give you more freedom in selecting your doctors, and give your doctors more freedom in selecting your treatments. HMOs will tell you what doctor to go to, and they will tell your doctor what treatment to give you, even if the doctor disagrees.

have you seen the movie "sick"?


well because many health care companies that offer HMO sometimes pay their doctors to reject an operation or not to diagnose people thoroughly! ( for example you might have some sort of cancer that is just starting to spred when they diagnose you they wont tell you that you have it) untill its 2 late.

Just recently some girl died at the UCLA hospital here in CA because her health care company denied an surgery to be conducted because they didnt feel like paying the money! GuESS WHAT HAPPEND!? after protests and UCLA doctors writing letters to the insurance company saying please approve the operation or else she will die! They do approve after it hits the news but they are 2 late the girl dies minutes after approval! very sad story but its true thats why HMO's suck!