HMO plans - Limited choice with less cost
HMO plans stands for Health Maintenance Organization and it consists of a tightly organized network of doctors and hospitals that all enter a contract with an insurance company to provide their services at a fixed price. The major benefit to this arrangement is that costs are kept relatively low because prices are negotiated ahead of time. But these cost savings come with some rather strict rules about which doctors you can see and when you can see them.
Because HMO plans require you to see a primary care physician first, and specifically one inside its approved network, you might be forced to abandon your family doctor if he/she is not approved by the HMO. Another limitation is that you will be required to seek a referral from a primary care physician any time you want to see a specialist. This can be a frustratingly unnecessary step for some patients who might already know which specialist they want to see.
PPO Health - More choice with higher cost
PPO health stands for Private Practice Organization and consists of a loosely organized network of doctors, hospitals, labs and care facilities that all enter a contract with an insurance company to provide their services at a predetermined price. Sounds like an HMO, right? Not quite.
The main difference that a PPO health plan offers its patients is a higher degree of choice and flexibility in managing one’s health care. Unlike HMOs, PPO patients do not need to see a primary care physician before going to see a specialist. In fact, under a PPO health plan, a patient can decide to see any doctor they choose any time they choose.
The downfall to this higher level of choice and flexibility is higher cost to the patient. These higher costs are necessary because the more loosely networked PPO cannot control costs as tightly as a rigorously maintained HMO. In the end, the choice you must make comes down to how much you are willing to pay for a higher level of choice over your own health care.
Which one should you choose?
Let’s look at a few easy scenarios first. If you already have a primary care physician, or a specialist you see for a specific problem you’ve had for some time, and those doctors do not belong to an HMO plan, than an HMO plan is most likely not the right choice for you. However, if you are relatively young and healthy and only see a doctor a few times a year, and you are impartial to which doctors will handle your care, then you might want to explore the HMO plans option and save some money.
Ultimately, the question you need to answer for yourself, regardless of your health plan, is whether the doctors who are taking care of you have your best interests in mind. There are plenty of people out who can say “yes” to that question under both types of plans.
Author Resource:- About the author
This article focuses on helping consumers understand PPO Health and HMO Plans rate choices and learn some of the basics of term health insurance before purchasing. The article explains what’s involved in the process of getting cheap PPO Health and HMO Plans.
