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 Posted: Tue Mar 03, 2009 5:04 am Post subject: HMO vs PPO |
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Hi All!
It seems that there are plenty of learned people available in this community. I’m glad that I’ve found you. 
I was all decided to buy health coverage before I was struck by the options available to me. I didn’t know that so many things you have to learn to choose the right coverage.  And, therefore I’m here. I’d like to ask a very stupid question to y’all.
What are the differences and similarities between HMO and PPO plans?
Curious_kid
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Curious_kid
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| Posted: Tue Mar 03, 2009 10:36 am Post subject: hmo vs ppo insurance |
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Okay, to begin with... the HMO plans, premium wise, are cheaper than the PPO plans. The co-payments with the HMO plans are typically low, at times even free. Now, you shouldn’t jump at the HMO plan before you know the cons.
HMO plans are very restrictive and may follow very strict rules with the referrals. With the HMO plans you can’t choose any healthcare provider, but have to pick one from the network. Therefore, if you opt for the HMO plan you might have to switch your current physician if he isn’t within the network.
Hope this helps.
~Jeremy |
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JeremyHolter
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| Posted: Wed Mar 04, 2009 3:52 am Post subject: |
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Often we come across the dilemma of choosing the best plans amongst the wide range of health insurance options. HMO vs PPO is only one such example. One needs to be absolutely sure about the services he is going to receive from the plan before signing the policy papers.
The concern is certainly not HMO vs PPO or disregarding one completely for the other, both have their places in the market only the buyer has to make the best decision for himself.
However, as Jeremy has rightly said don't jump to one before you check the other options too. Take your time in reading the fine prints of both the HMO and PPO plans.
Thanks,
Rupert |
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RupertWBradson
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| Posted: Thu Mar 05, 2009 11:45 am Post subject: |
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Agreed, that the debate of HMO vs PPO is an old one. OP you can choose either since both have their advantages and disadvantages. One also needs to use the benefits wisely to keep the costs low.
Following the basic rules of health care would help one to stay in good health and eventually would reduce the expenses on health insurance.
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Sevan
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| Posted: Thu Mar 05, 2009 11:56 am Post subject: HMO vs PPO |
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I’d prefer the HMO over the PPO since this way I would be able to avoid the hassle of filling-up the claim forms.
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Choosy_pearls
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| Posted: Fri Mar 06, 2009 11:20 am Post subject: |
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Hi Curious_kid
You may opt both for HMO and PPO. HMOs are comparatively cheaper than PPO or any other plan. The premiums are lower too. If there is a co payment or any fee, they are low too. However, such plans tend to be quite restrictive and do not allow the policyholder to choose a physician outside its network. If you need to see a specialist, you will need a referral from your primary care physician first.
On the other hand PPOs are more expensive. This plan allows you to visit a doctor outside their network but for that you may have to pay more out-of-pocket. However, no referral will be required..
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Readmymind
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| Posted: Fri Mar 06, 2009 11:27 am Post subject: |
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| I do not know if this applies but maybe someone will know. My plan is PPO. I know any time I need a test like say CAT scan, or maybe some type of medical equipment it has to go through an approval process. Sometimes this can take a few days even if the tests or medical equipment is labeled urgent. I never had HMO so I am not sure if they have the same rules and guidelines. I do know that it PPO is restrictive on some thigns. If you go out of network you must swollow a, lot of the costs but one good thing is a lot of places are in network. |
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fireyone
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| Posted: Sat Mar 07, 2009 7:23 pm Post subject: |
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| HMO plans are more popular due to their market launch as a substitute to individual policy for servicemen. There are mixed reactions on this debate ever. But HMO are required to have less documentation. There is anothere good option, point of service (POS) that has tried to gather the features of both yet not so popular. PPo also are costlier when you are dealing out of group but flexibility of referring by physician is not strict in them. |
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VIJAYRAJ
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| Posted: Wed Feb 17, 2010 10:52 am Post subject: hmo vs ppo |
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HMO plans are not always cheaper. They used to be much cheaper than PPOs but that it is not always the case. Many people who have chronic health problems choose HMO plans to keep their out of pocket costs low so the insurance companies have caught on to this rend and have started to move HMO rates up.
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altruance
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| Posted: Wed Feb 17, 2010 12:58 pm Post subject: PPO vs HMO |
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| Preferred Provider Organizations plans are expensive but they do not limit your choice. You will be able to see any doctor under this plan. Health Management Organization plans are cheaper but they restrict your choice. |
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Veronica
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| Posted: Sat Nov 13, 2010 5:19 pm Post subject: Hi |
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hi veronica,
so you mean there are ppo plans and hmo plans? and what do you mean by they do and do not limit your choice? choice of what? also do insurance companies offer these plans? can you put all this together to make it make sense to me?
thanks,
nicholas |
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Nicholas_peters_
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| Posted: Sun Nov 14, 2010 12:46 am Post subject: |
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also does anyone know if a provider is the ppo and or hmo?
thanks |
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Nicholas_peters_
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| Posted: Sun Nov 14, 2010 1:04 am Post subject: |
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Let's see if I am correct. I did some research and was able to find something. An or the insurance company is the HMO or the PPO right? And the policies they offer can be called HMO or PPO or more specifically for example Medicare HMO right? Can someone ellaborate if needed?
Thanks,
Nicholas |
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Nicholas_peters_
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| Posted: Sun Nov 14, 2010 3:09 am Post subject: |
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The insurance company isn't an HMO or PPO. The policies that they offer can be HMOs, PPOs, POSs, etc.
Many carriers offer more than one type of policy. In my state Connecticare solo insurance sells both HMOs and POS policies.
An HMO policy is often cheaper because it offers out-of-network care only during a medical emergency. This costs the insurer less because they have negotiated lower fees with the doctors and hospitals in the network.
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Alston
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| Posted: Sun Nov 14, 2010 4:50 pm Post subject: |
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compared to what maxherr said in another statement it is. I will take what i learned from both. from "If I go to dr. who is in my network" post he said, "Yes. It's the company that creates the network. Originally, PPO networks were created by the doctors/hospitals to compete with the HMOs -- offering the advantage of more freedom of choice. But they were quickly overrun by the same companies offering the HMO plans -- doctors really don't know that much about running an insurance plan . . . they went to school to learn to take care of people instead.
There are, however, several HMO/PPO organizations that are "physician-owned". Doesn't necessarily mean they are better or have lower costs, but their motivations for being in business may be a bit different. Nevertheless, they are in business for the same reason as any other insurance company . . . to make money."
So I would say it is the insurance company. |
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Nicholas_peters_
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