The Advantages & Disadvantages of PPO's & HMO's

Finance

  • Author James Dalton
  • Published September 22, 2007
  • Word count 523

There are countless different options that are available when it comes to health care insurance. Each one offer something different and it depends on the individual and what they are looking for. One of the more popular health insurance choices are managed care plans. The two most popular plans being the Health Maintenance Organizations (HMO) or the Preferred provider organization (PPO). This article will examine the advantages and disadvantages of the two plans.

The HMO offers many advantages which can be quite beneficial. The HMO allows for lower health premiums that will affect both employee and employers for worked based health insurance. The low cost of these plans make it very attractive for these individuals. Employers love it because they don't have to pay that much when it comes to monthly premiums. Employees love it for the same reason, it saves them some money. Another advantage lies with the fact that there is a wide selection of physicians and hospitals on HMO plans and this mean there is bound to be some close to where they live.

The major disadvantage of a HMO plan is that you are only allowed to go to a prescribed list of doctors. This is known as the HMO's private network and if you do plan to go outside, the HMO will not cover this care. If you do get permission, then the HMO will charge you a substantial amount or at times the entire cost. The HMO has another disadvantage of when it comes to the use of specialists. If you have used a certain specialist for years, depending on the medical condition; When it comes to see that specialist, you need to be referred by the HMO to see them. If you do not follow this, you may be asked to pay the entire cost of the visit.

The PPO has many advantages. One such advantage is that with a PPO plan, you have a greater choice in the type of physicians that you can choose from. You are not limited like an HMO plan. This works especially well as you can receive referrals for specific doctors in the event that you move. Another big advantage of the PPO is the fact that you do no have to report to primary care physician. The HMO your PPC is responsible for every aspect of your health care. So with the PPO if you need to see a specialist, you do not need to get a referral or anything to go and see your specialist.

The PPO is not without its disadvantages. The PPO is more expensive than your typical HMO plan. They also will not pay the full cost of coverage, if you decide to go and get medical care outside of their network. The cost for this may vary and it may

In the end both the HMO and PPO have their own advantages and disadvantages, this all depends on the individual or the employer. They need to weigh the options of both managed care plans and see which one will fit and benefit their lifestyle. Each one has its highs and lows so choose wisely.

James Dalton has an interest the health care system. He has written on a wide variety of topics as it relates to Indianapolis Insurance. He specifically focuses on Indianapolis Health Insurance. If you want more information visit Birmingham Insurance.

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