PPO or HMO: The Difference It Means in Health Insurance

Each year, US residents must choose their health insurance. Knowing the difference between PPO and HMO can help consumers decide which type of coverage works best for them. Here at Linda Dugan Insurance, we want our clients in Astoria, OR to understand the choice between an HMO and a PPO.

HMO Insurance

The abbreviation HMO refers to a Health Maintenance Organization. This type of health insurance limits the purchaser to its specific physicians and medical centers. Typically, an individual would need to obtain a referral from their in-plan primary care physician to see a specialist. They would have added steps to complete to see a physician outside of the HMO plan choices. In an emergency, the individual can obtain treatment at any facility, but they will pay for using an out-of-network option.

Because you give up choices and agree to use in-plan medical providers, the HMO plans cost less in premiums. You may get to choose your deductible.

PPO Insurance

The abbreviation PPO refers to a Preferred Provider Organization, an insurance option that lets the individual choose their physician regardless of the network. PPOs have medical provider networks, and visits to the in-plan options may cost less. Unlike HMOs, a PPO does not require referrals. The patient can visit any specialist they choose.

PPOs charge a bit more in premiums for the privilege of these choices. They sometimes offer specialty coverage, such as wellness plans.

Making Your Choice

When choosing between an HMO and PPO, consider your medical needs. If you have a pre-existing condition that requires a specialist, consider a PPO. Without any existing issues, check with your doctor to determine which insurance options the office accepts. Choose an HMO that it accepts to work around the choice issue.

Contact Us Today

Contact Linda Dugan Insurance serving Astoria, OR, and the surrounding area with health insurance. Let us help you purchase the coverage you need.