When selecting a health care plan it is important to understand and choose the right network of health care providers that fits your needs. Both HMOs (Health Maintenance Organization) and PPOs (Preferred Provider Organization) offer access to quality health care professionals. So what are the major differences between to the two networks?

HMOs:

HMO constitutes an organization of health care providers contracted with insurance companies that offer services at a fixed price. With an HMO, health care providers cap the patients they see in an effort to provide better service to their client base.

Can tend to be very restrictive in regards to their rules and health care providers that you can see. Specifically, you must have a primary care physician in their network, and if you want to see a specialist you must first receive a referral from you primary care doctor. Furthermore, you are unable to see health care providers out of your network unless it is an emergency.

The major benefit to a HMO plan comes in cost. For example, your doctor copayments are between $5-$25 dollars or can even be free.

PPOs:

PPO plans also have a contractual relationship with numerous health care providers; however their network of providers is significantly larger than with an HMO.

PPO plans are more loosely organized and restrictive than a HMO. You will not need to receive a referral from a primary care doctor to see a specialist. As long as the specialist is in network you are able to benefit from their services before going to your primary care physician.

Furthermore, you are able to see health care providers who are not in network and still receive substantial coverage.

MyInsuranceExpert.com primarily works with PPO providers. They understand it is important to increase an individual’s ability to have as larger network of providers, and to gain access to them as easily as possible.