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PPO Vs HMO Whats the Difference and Which is Better
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Next Step: Take the PPO Vs. HMO test for yourself - http://www.giangolainsurance.com/heal... • What Does PPO Mean? • PPO stands for Prefered Provider Organization. This type of plan offers a higher level of reimbursements when you receive treatment from a “preferred” doctor or hospital. • In less fancy insurance terms, you pay less. • This is also known as your health insurance company’s network. These “preferred” providers offer their services to you at a cheaper rate if they’re in your insurance company’s network. You even have the ability to see non “prefered” doctors with this plan, they are just consider out-of-network doctors. • PPO’s have dominated the health insurance landscape for the last 10-15 years. • What Does HMO Mean? • HMO stands for Health Maintenance Organization. This plan type works a little different from a PPO. • Instead of being able to choose from a list of doctors at a wide array of facilities, you are strictly limited to doctors and facilities contracted with that health insurance company. • The goal of this plan structure is to have a primary physician manage your care. The most famous example of an HMO structure is the company HealthSpan, formerly known as Kaiser Permanente. • These plans generally are less expensive than a PPO plan, however that is in exchange for a limited selection of doctors and hospitals. • • Let’s Take a Closer Look • So I’ll ask you again, how many doctors do you want to be able to see if something really bad happens? • The answer to that question is the answer to your internal PPO vs. HMO debate. • But if you want to go even deeper, here’s what you need to think about. • When does a HMO plan Make Sense? • This is a hard question to answer since it will always come down to personal preference. • But, this is how I like to explain it to clients. • If there is a HMO plan that has doctors close to your home that you like and trust and also has an adequate number of hospital facilities, that’s a decent first step. You also need to be able to save a considerable amount of money on your health insurance payment every month. • Finding both of those together is the tricky part. I have yet to see a HMO plan that offers enough savings to consider recommending one to a client. • When you only save a couple dollars every month, you have to ask yourself if it is really worth it to limit yourself that severely when it matters the most. • I've never been able to answer yes to that question for a client.
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