HMO vs. PPO: Which is Which?

Choices are usually good, but they can be tough, especially when it comes to something as complex as your health insurance. For instance, figuring out if you’re better off picking a health maintenance organization, or HMO, rather than a preferred provider organization, or PPO, insurance plan can be downright confusing if you don’t know the key differences between the two options.

Health maintenance organizations (HMOs) cover only care provided by doctors and hospitals inside the HMO’s network. HMOs often require members to get a referral from their primary-care physician in order to see a specialist while preferred provider organizations (PPOs) cover care provided both inside and outside the plan’s provider network and members typically pay a higher percentage of the cost for out-of-network care.

Obviously, the choice depends on your particular needs. PPOs tend to be more flexible, but HMOs are generally less expensive. Because you don’t need to get a referral before seeing a specialist, you might prefer a PPO if you have a medical condition that requires specialized care. But if ongoing out-of-pocket costs are a major concern, an HMO may be a better choice–there are no deductibles, and co-payments are typically lower.

That’s why Healthcare Enrollment USA is here for us. It is an insurance agency compiled of licensed agents all across the United States. They help thousands of people enroll in affordable health plans every year to avoid tax penalties. They give free quotes on available plans for us to get the coverage we deserve. And they provide free enrollment assistance for a qualified health plan. All at no charge for their services.

Health insurance is a complicated decision. There’s no sugar coating in that but it’s important for people to know that there is help available to them.


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