It is important to first understand the difference between a HMO health insurance plan and a PPO health insurance plan. There are a number of things you need to consider before you find out which insurance option is a better choice for you. It is important for you to understand that besides paying the monthly insurance premiums there are a number of additional things that you need to consider. The abbreviated form of PPO is Preferred Provider Organization while the abbreviated form of HMO is Health Maintenance Organization.
How do I know that I bagged the right deal?
Many people get confused with the different types of medical insurance acronyms and fail to understand their full meaning even after obtaining the insurance plan. There are a few primary differences that you have to understand between a PPO vs HMO health insurance plan. One of the basic differences between both the plans is that in a PPO health insurance plan you can get free medical care and treatment from almost any medical provider. Here it is not important for the medical provider to be the participating member of the PPO network.
Whereas a HMO network on the other hand who is mainly responsible of maintaining the health of those taking their plans, requires the insured person to select a primary care physician from the HMO network itself. The HMO doctor is responsible to refer you to other specialist doctors within the same HMO network for specialist care. Here the person has to take a referral from the primary care physician before seeing the specialist. When you study the services of both the PPO and the HMO it is up to you to decide, which service is best for you.
The PPO and HMO debate:
A number of pros and cons are attached with the PPO versus the HMO health insurance plans. These issues can be issues of debate, but it is for you ultimately to decide the right health plan for yourself. One of the primary advantages of the HMO is that you do not have deductibles to meet and your premiums generally tend to be lower. Your overall health is maintained by just one primary care physician and you have the benefit of referring only one physician. By referring to just one doctor you will automatically develop familiarity with the doctor and the doctor in turn is familiar with your medical background.
This makes it easier to develop a better rapport with that doctor to suit your medical needs. The only drawback with the HMO is that you are restricted to obtain medical care from just one doctor as you cannot approach a hospital out of the network. It is only in an emergency case where you will approach a doctor outside the network. As far as the PPO is concerned you are not bound to one doctor at all and you don’t have to obtain a referral from a primary care physician before you go to see another specialist.
Professionals from outside the PPO can be approached to get medical care under certain circumstances. Higher premium is the only drawback of a PPO and deductibles have to be met, which means additional expenses for the pocket. A significant outlay is required for both the HMO plan as well as the PPO plan, because the premium you are going to pay on health insurance and their co-pays do not get cheaper. So your money as well as the convenience the plan provides you will help you to decide between the PPO and the HMO health insurance plan.
