Choosing a health insurance plan can be confusing. There are so many terms to learn, like HMO, PPO, deductibles, co-pays, and more. How does one know what plan to choose, and which one is best for them?
HMO vs PPO
Most health insurance plans are structured as either a HMO or a PPO plan. What's the difference?
HMO: A Health Maintenance Organization plan offers a network of health care providers. Your primary care physician and all your doctors are chosen from within the network, which makes the premiums more affordable than other health insurance plans. If you are healthy and flexible on which doctors to see, this might be a good plan for you, since many of the physicians in the network also offer preventative services. Co-pays are low, and deductibles are paid at the time of service.
PPO: A "Preferred Provider Organization" plan gives you the freedom to choose almost any medical facility or provider for your healthcare needs. You don't need a referral from your primary care physician to see a specialist, as in the HMO plan, but there is an annual deductible. Claims from visits to specialists outside the network may be submitted for coverage, too. This plan might be a good fit for someone with ongoing health issues that requires treatment by specialists or specific doctors.
The important factor in choosing a plan that is right for you and your family is whether or not it is going to cover your health needs. This may seem like a simplified explanation, so it is important to review plans with your provider to make sure you choose the one that is best for you.