Evaluating an HMO vs PPO networks does not have to be difficult if you have the answers to the right questions beforehand. In previous articles we looked at the differences between the two but how does the differences between the two translate to the differences that you see as far as quality of healthcare, and in terms of what it will cost you?
Lets look at those questions and answers that are commonly asked in evaluating HMO vs PPO:
What are the choices I will have concerning doctors?
HMO networks require you to get services through your primary care physician who then referrs you to specailists within the HMO nework. So in other words, you do not have much choice as to who you see or are referred to.
PPO networks allow you to choose any provider, even if they are out of network. You just have better coverage if you choose a provider that is in the network. You also do not have to have a referral to see a specialist and can freely switch between doctors if you so choose.
How do the monthly premiums stack up when looking at HMO vs PPO plans?
HMO plans usually cost much less in terms of monthly premiums when comparing like benefits in a PPO plan. Likewise, you can get cheaper plans from PPO companies that have reduced benefits that are not usually available from HMO providers.
What about out of pocket expenses?
HMO plans clearly win here. In exchange for more limited choice and less control over your healthcare options, you benefit greatly by having lower copays and other out of pocket costs. In a PPO plan, you could have much larger out of pocket costs if you choose to use an out of network provider.
What about availability and size of these networks when comparing an HMO vs PPO?
HMO networks usually tend to be smaller networks than the PPO networks and are usually concentrated in major metropolitan areas, where PPO networks are more accessable to areas outside of urban centers.
So how do I choose between a HMO vs PPO?
It comes down to what you value. Do you like a lot of choices when it comes to your healthcare? Choose PPO. Do you like lower premiums and great benefits that will reduce your costs? Choose HMO. What is availble near where you live? Choose whichever is more conveinient.
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