HMO vs. PPO

In America the cost of healthcare is increasing, with no sign of becoming any less in the near future. One way to combat this is through the use of health insurance. There are many types of health insurance, but one of the most popular types is managed care. In this article we will examine two HMO and PPO managed care plans and will compare and contrast to see the differences and similarities between the two.

HMOs and PPOs are similar in that both members need to choose a primary care physician (PCP). The PCP is responsible for the majority of medical care for members of the health plan. If a member needs to see a specialist, the PCP should be consulted and to provide a reference before the specialist can be seen. E 'with the appearance that the HMO PCP and PCP differ. As said, it is necessary for a member of the HMO to have a PCP, this is not true for the members of the PPO. PPO members may choose a PCP, if you want, but do not have to. This also means that members of the PPO may refer to a specialist of their choice.

When members enroll in several managed care health plans, HMO and PPO there are usually several provisions associated with both. A condition for this medical coverage. Both HMO and PPO members are covered, when seeking or receiving medical care within the private network. The plan will cover all expenses associated with their treatment. The two managed care plans differ when it comes time to receive treatment outside the network. HMO members do not receive coverage or benefits if you decide to get medical treatment outside the private network. If you do not insist to do so must pay their own pockets. PPO members can go outside the network of care, but the benefits of coverage would be substantially lower. To encourage members to stay and receive network coverage, PPO often times gives financial benefits that encourage their members to stay within the network.

In closing, the choice of the best managed care plan for you is based on the individual. Both the HMO and PPO have their advantages and disadvantages. Depending on what is the best choice that fits the lifestyle of the individual, then you should proceed with the managed care plan. HMO is much more restrictive and do not have the flexibility in your choices. You do what is provided to you and if you go outside of their network will not receive any benefit. The PPO allows a certain amount of flexibility, but the financial rewards are decreased. They are not tied to a network such as PPO and this increases the options you have. As mentioned the difference between an HMO and PPO is all a personal choice and it will depend on what the person wants out of the plane .......