The Differences Between an HMO and PPO Health Plan

When researching health insurance plans, there are many items to consider. There are two plan design options to choose from, and knowing the difference between them is very important in determining which coverage is best suited for you.

One of the plan options, Health Maintenance Organization (HMO), commonly requires you to choose one Primary Care Physician (PCP) and all services will go through this physician. If you need to see a specialist or receive a service that is outside the realm of your PCP’s practice, you will need to make an appointment with your PCP first, who will then refer you to the appropriate specialist. For any service that would be considered out of network under your health plan, these may not be covered under your HMO insurance coverage.

The additional plan option, Preferred Provider Organization (PPO), provides more flexibility in your healthcare. You are not required to choose a PCP under this plan option, and you will not have to receive a referral to seek medical services outside of your primary care. The PPO plan also allows you to pursue medical services out of network, which may come at a higher cost.

Questions on what health plan is best for you? Contact VAST today where we have a dedicated team of experts who can assist in finding the perfect fit for your healthcare.