Notice: The application is available daily from 5 a.m. to 1 a.m.
The application is available daily from 5 a.m. to 1 a.m.
When you’re shopping for a health insurance plan, you can choose from several options. It’s important to understand the difference between plans, so you can choose the one that’s right for your lifestyle. Let’s take a look at what makes these plan types different from each other.
An HMO (Health Maintenance Organization) is a health insurance plan that establishes a network of health care doctors, facilities, and hospitals to provide health care services to consumers. With an HMO plan, you pick one primary care doctor. All care goes through that doctor. This means you’ll need to ask your doctor for a referral to a specialist before you can see any other health care professional, except in an emergency. HMOs often focus on preventative and wellness care. u To avoid unexpected medical expenses, you should always confirm that a specialist is in-network with your HMO. HMO plans generally have lower premiums due to the managed care, in-network provider model.
A PPO (Preferred Provider Organization) is a type of health plan that establishes a network of doctors, facilities, and hospitals that will provide health care services at a determined rate. PPO plans provide some flexibility. For example, you can see any health care professional you want without a referral—inside or outside of your network. Choosing a specialist in your network means smaller copays and full coverage. If you choose to seek treatment from a specialist who does not participate in your network, you'll have higher out-of-pocket costs, and not all services may be covered.
PPOs often have a set fee or rate that they will pay an out-of-network provider. If the care provided costs more than the set fee established between the the doctor and the insurance company, then the consumer will be required to pay the difference. A PPOgenerally has a higher monthly premium cost than that of an HMO due to the increased flexibility a PPO offers.