What are the differences between HMO and PPO health insurance?

Choosing the right health insurance can be a daunting task when you are not familiar with the common acronyms denoting different plan types. HMO and PPO are only two of the myriad terms you will encounter when browsing insurance offerings. Knowing the difference between plans makes it possible to choose the insurance that best fits your monthly budget and health insurance needs. Consulting with an insurance agent at Redden Insurance Agency serving Bradley WV can also help inform your decision. 

Health maintenance organizations

Health maintenance organizations, or HMOs, are one of the most common types of health insurance plans but can also be the most restrictive. These plans are somewhat lower in cost and feature a network of doctors, hospitals and care providers. You are typically required to use plan enrolled physicians, and referrals are needed for many types of specialty care. This includes seeing a specialist or visiting a care provider outside the network. 

An HMO typically provides streamlined payments in the form of co-pays or co-insurance and claims are easily filed by the healthcare provider, eliminating the burden of filing a personal claim. 

Preferred Provider Organizations

A preferred provider organization health plan, or PPO, also features a network of doctors, but the use of the network is more flexible. A primary care physician is not needed to refer visits to specialists, and it’s typically easier to visit an out-of-network provider when compared to an HMO. However, additional costs may apply when out-of-network services are used.

Standard co-pays apply based on the deductible in your health plan documents, and monthly premiums may be slightly higher versus a HMO due to the plan’s added flexibility.

Unsure which plan is right for you? Visit the Redden Insurance agency serving Bradley, WV or call today to schedule a consultation with an experienced agent. An agent will review your budget and health insurance requirements before presenting a variety of insurance options.