My company is switching from HMO to PPO. I was wondering what is the big difference between the two? Is one better than the other?
2006-11-10 18:40:50 · 3 answers · asked by Jay S 5 in Business & Finance ➔ Insurance
HMO, means Health Maintence Organization- this means that a portion of your premium goes directly each month to this Organization (your Doctor)- that one Doctor you pick collects this money, and theoretically that money is supposed to be used for "your" healthcare (the argument of a HMO is that Doctors are encouraged not to give you the patient care in order to save money). Not hard to figure out that if you are very healthy and never go to see the Doc. he/she makes out like a bandit!.. The nice thing about HMO's is that when you do go in to the doctor for a Xray, or diagnostic you will only pay a small copay usually 5. or 10bucks! Because remember you have been prepaying since you signed up.
PPO plans, Preferred Provider Organization, with this type of plan- you can go to literally thousands of doctors and receive discounted and pre-negotiated rates (benefit of ppo is that you can pick from thousands of docs) the downside of a PPO plan is that the Docs get paid for what they bill (the argument can be made that excessive testing and billing can be found in a PPO plan) You are left to pay Deductibles, copays, and "CoInsurance" this means that you will pay more out of pocket when you utlize the plan (especially if the doctor recommends lots of diagnostic ie. blood tests, MRI's ET.
I personally believe it is still all about the Doctor you pick, both types of plans can be wonderful if the Doctor is a ethical and great person.
2006-11-11 15:07:35 · answer #1 · answered by Anonymous · 0⤊ 0⤋
With an HMO you only have certain amount of PCP's to choose from. With PPO you can pretty much chose what doctor you want to see if they accept PPO's. Terms of coverage wise... PPO will have a better annual deductable and out of pocket. might be a bit more expensive tho.
2016-05-22 04:42:59 · answer #2 · answered by ? 4 · 0⤊ 0⤋
Depends on your marital status. HMOs are better for families. PPOs are better suited for single people.
2006-11-10 18:50:55 · answer #3 · answered by Icewind 2 · 0⤊ 0⤋