Which health insurance is better HMO or PPO?

Answer 1

A PPO is better because you can go and see a specialist without getting a referral.....but a PPO is normally slightly more expensive than an HMO.

An HMO means that you have a "primary care physician" and all appointments are always through him/her first. Before you can ever see a specialist, you always have to see your primary care physician to get a referral and permission from the health insurance. Go and see a specialist without getting a referral from your PCP means you will pay for that out of pocket regardless of whether it was appropriate for you to see that specialist.

If you are a healthy person and rarely are sick, an HMO might be ok for you because it would give you health insurance at a lower cost. If you, however, need appointments from time to time and don't like having to go through a lot of red tape and filling out forms to see a specialist, a PPO is better for you.

Just depends on your situation. I'm a cancer survivor, so I'm on a PPO.......anytime I have a problem, I'm the one choosing which doctor I see about it.....not my primary care physician.

By the way, when you are on a HMO, your primary care physician actually LOSES money out of his/her pocket any time a referral is made.

Answer 2

Depends on what you're looking for in a plan.

If you only go once a year for a checkup and maybe get sick once or twice a year - then HMO isn't a bad idea.

If you have health issues that may require specialists or you tend to travel a lot, you may want the out of network abilities that PPOs allow.

The other issue is - HMOs often have just a copay, where PPOs may have a copay, a deductible, coinsurance (where you pay a percentage) or any combination of the three. HMOs may not pay for any procedures, or pay limited ones.

My advice: assess what you need then make the decision based on that. Good luck!

Answer 3

PPO's give you more freedom to see which doctor you want. You have more control over your health care decisions. HMO's require you to see a doctor in their network. Also, if you need to see a specialist, often times you need to see your doctor first, and then get a referral.

However, with HMO's there's less paperwork, and you never really see a bill. You just pay your co-pay, and they take care of the rest.

Personally, I think HMO's do what's best for them (cost effective) more often than they do what's best for the patient.

Answer 4

It all depends on your own situation. If you are on medication, like for allergies, or you need medical care on a regular basis, an HMO may be better for you. If you are rarely sick and do not need medication, a PPO could be better. It would be cheaper in the long run.

Answer 5

PPO is better you can pick the doctors you want to go to just make sure that they take your health insurance. With HMO you have to go to the doctors they tell you.

Answer 6

If the PPO has a higher premium, it must offer better benefits. But make sure you see how many and who the providers are before you sign up. Aetna will provide you with the info. Good luck

Answer 7

PPO if you have money! HMO if you don't!