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HMO vs. PPO , which is better?

Health care in the United States Government Health Programs Federal Employees Health Benefits Program Indian Health Service Medicaid / State Health Insurance Assistance Program (SHIP) Medicare Prescription Assistance (SPAP) Military Health System / TRICARE State Children's Health Insurance Program (CHIP) Program of All-Inclusive Care for the Elderly (PACE) Veterans Health Administration Private health coverage Consumer-driven health care Flexible spending account (FSA) Health Reimbursement Accou

Preferred Provider Organization (PPO) A type of health plan that contracts with medical providers, such as hospitals and doctors, to create a network of participating providers. You pay less if you use providers that belong to the plan's network.

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HMO and PPO Reviews

comparman

compargram

@comparman

HMO

Pros of HMO:

  • Premiums are typically low
  • Easy to find healthcare providers
  • Cash rewards and other perks are often offered

Cons of HMO:

  • Must choose a primary care doctor
  • Need a referral to see a specialist
  • Cannot use out of network providers

comparman

compargram

@comparman

PPO

PPO Pros:

  • There is no need to choose a primary care physician with a PPO program, so that gives employees a little bit more flexibility when choosing healthcare.
  • Employees also have the option of going out of network for care as well, which is not an option in some other types of plans.
  • One of the biggest benefits is that there is very little paperwork for both the employee and the employer.

PPO Cons:

  • For employees, a PPO is one of the higher cost options. That does not necessarily mean the employer will pay more, but it could have that implication.
  • Employees may need pre-authorization for certain types of care, and this might be something that the employee would have to handle themselves.
  • If the employee needs to move out-of-network, then costs can add up quickly.
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