PPO v/s HMO Health Insurance

Investing in a health insurance plan should be a
well-thought-out move. When you look at the options available to you in the
insurance market, you'll notice that some programs are HMO, while others are
PPO. What do these acronyms mean and what's the difference between them? Let's
find out.
 
HMO

HMO stands for "health maintenance organization". The beneficiary of
an HMO insurance plan is confined to receiving treatment from a network of
medical professionals. It also is a managed plan that allows the insurer to
save on costs. 

HMO insurance coverage requires you to meet with your primary care specialist
for any health complaints. If he/she is unable to treat you, they will refer
you to an in-network specialist. However, this rule is invalid for emergencies
and routine-care, in-network visits. 


Since HMO plans restrict you to medical care from a network of medicos, you are
able to enjoy maximum insurance coverage for the services received as per your
insurance plan. Even pharmacies that cater to your prescriptions on an HMO plan
lie within specific locations.


Also, the average monthly premium for an HMO plan is much less than that for a
PPO plan. So your out-of-pocket costs for an HMO plan are quite low as these
don't require annual deductibles and only charge a co-pay at the time of
service provided from within the network.

HMO beneficiaries do not need to file insurance claims by themselves, as their
insurance company pays the healthcare provider directly.

In conclusion, an HMO plan serves individuals and families who'd like the
familiarity of a primary care physician who works with them for years to
coordinate their healthcare and keep a tab on their wellbeing.

PPO 

A PPO plan, or a preferred provider organization plan, gives the beneficiary of
the policy the option to choose their healthcare provider from anywhere they
want. These healthcare providers need not belong to their network, and the
scheme also qualifies as a managed care insurance option. 

Under a PPO plan, while you still have a network of medical providers at hand,
you are not mandated to receive healthcare services from just them. You may
engage the services of any healthcare professional you like. You can also get
your prescription filled from any pharmacy under this plan. 

Since a PPO plan lets you avail healthcare facilities from outside your
network, the premium you incur on this plan is higher than you would for an HMO
plan. Also, PPO plans often come with deductibles, co-pays, and a co-insurance.

Additionally, PPO patients may sometimes need to pay medical providers outside
their network for their services first. After that, they may file a claim with
their insurance company to reimburse this expense. 

If you happen to live in a remote area or are someone who travels frequently,
an HMO insurance plan may not be profitable for you. A PPO plan would be more
suited to your health insurance needs. 
Phoenix Family Medical Clinic accepts both HMO
and PPO plans. So you can confidently walk into our clinic and have your health
issues treated without worrying about the expenses of your medical treatment.

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