HMO Or PPO - Which One Is Right For Me?
Rising healthcare costs force us to need to use an HMO or a PPO.
Which is the right choice for you, though? These plans are
somewhat different and it all can be relatively difficult to
understand. Here is a breakdown of the differences between the
two so that you can make the right decision overall.
What You Need To Know About HMO's
The HMO is rated slightly higher by Consumer Reports over the
PPO. But, the difference in scores is relatively low. These
plans are a good choice for those individuals and families that
need to keep their out of pocket expenses low as well as those
who are okay with allowing the insurance company to choose their
doctors. Believe it or not, going with this type of coverage can
also help you to keep your bills coming in more smoothly as
well.
The average cost per family is about the same or lower than that
of a PPO. But, the deductible is significantly lower. It also
has a low rated co payment that is due at the time of service,
in most cases.
The problems that can occur with the HMO though are several. For
one, you may have more trouble getting the help and care that
you need and you may have to wait longer to get it as well.
Often, when you need to seek the assistance of a specialist or
another doctor, you will need to seek approval for the care
first.
The PPO: What It Has For You
On the flip side is the PPO. Those who have chronic pain often
do better on this plan. If you would like the ability to choose
any doctor that fits your tastes and preferences, the PPO is the
way to go. You choose the doctor in this plan. The deductible in
this coverage often varies depending on who the doctor is and
what role he or she plays in the plan. For example, you will pay
more for a non-preferred provider as opposed to going with the
preferred provider.
The bad side to the PPO is that there are often a number of
problems with billing. In fact, it is rated that the PPO will
face upwards of three times as many problems getting the right
bills to you than with the HMO. You will also have more problems
getting hold of the plan as well.
So there you have it, an overview of the pros and cons of HMO &
PPO. If this is the starting point of your research, we
recommend that you talk directly with people enrolled in the
plans that you are considering.