We are a couple with no children. On the coming open enrollment, we are planning to apply for a health insurance and trying to decide between an HMO and a PPO. Can you cite some advantages each of these has over the other?
An HMO generally requires policy holders to obtain medical services through its affiliated medical providers to qualify for health insurance coverage. This limitation usually extends to the prescription drugs they allow. Even with these limitations, however, HMOs have guaranteed number of specialists and facilities that have signed agreement with them. On the other hand, a PPO offers a more flexible coverage of service compared to that of an HMO. You may choose medical providers aside from those that are under the PPO coverage. This is especially helpful if you are in a place where you have very limited network of PPO-affiliated providers and you travel a lot. In addition to this, referrals are not anymore necessary in a PPO compared to that of an HMO, where you are generally required to submit referrals every time you visit a doctor or use a medical facility. Nevertheless, a PPO generally has a higher monthly premium aside from copays that you should give even if you obtain your service from a PPO-affiliated provider. An HMO is usually a good choice for those people who lived in an area that has a wide network of HMO participating doctors and facilities. As for those people who travel a lot or have their own preferred doctors and medical hospitals that are not affiliated on a certain insurance program, the best option is PPO. Answer by general public - June 19, 2009 @ 5:57 pm No CommentsNo comments yet. Leave a comment |
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Many are satisfied with an HMO plan due to its lower monthly premium, lower deductible, as well as less than out-of-pocket expenses aside from the agreed copay if the services used are from certified HMO medical providers.
