HMO or PPO???????

[berger034]

ok the title says it pretty much says it all. i have the option to get either or but the ppo would be the best bet.

 

[Ameesh]

in general ppos are better but we need details on both plans to tell you.

 

[mchammer187]

hmo is cheaper

and probably just as good and the only thing is you have to select a doctor within the network


PPO (Preferred Provider Organization) You must see physicians who are providers within the network of your insurance plan. You pay a co-pay for an office visit, the price varies dependant upon your plan. If you see a doctor out of network or go to a hospital that is out of network, you are covered but your out of pocket expense is higher.

HMO (Health Maintenance Organization) Your Primary Care Physician (PCP) must be on the list of your plan. This PCP will provide your entire healthcare needs. You must see the doctor listed as your PCP on your card. If you choose to see another doctor, even within the network, your HMO will not cover the bill, unless they have been informed of the change and accepted it prior to your doctor visit. If you chose to see a physician outside of the network, you would be responsible for the entire bill. Should you need to see a specialist, you will be referred by your PCP and it will be a specialist within the network of providers. Should you choose a specialist out of network (not on the provider list) these will not be covered services. The same would apply to hospitals. Although your out-of-pocket expense is minimal, your freedom of choice is very limited.

 

[Schadenfroh]

i would go with PPO from some of those laws they just passed regarding HMOs

 

[pulse8]

PPO is only good if you can afford the out of pocket expeses that go along with it.