Phone Icon

Which is Right for Me – HMO or PPO?

HMOs are Health Maintenance Organizations that offer a wide range of services through a network of healthcare providers. These providers agree to offer their services for a negotiated rate with an insurance plan. If you choose this type of plan, you pick a primary care physician who will provide most of your care and refer you to a specialist when necessary. These in-network plans may charge a deductible or co-pay for medical services. Generally, out-of-network services are not covered except for emergency services.

PPOs are Preferred Provider Organizations, which means you get your medical care from doctors or hospitals on your insurance company's list. This plan gives you the flexibility to choose medical providers without referrals inside and outside the PPO network. However, if you go outside the network, your provider expenses may be partially covered or not at all.

If you'd like your doctor to coordinate your care at a lower cost, an HMO plan might be right for you.

If you want to choose your doctors and specialists and cost is not prohibitive, a PPO plan might be the right fit.

 

Read next: Making Sense of Health Insurance Terms.