HMO vs. PPO: What’s the difference?

Hello i'm kat perez and i'm one of the founders of health sherpa i'm here today to explain the differences between an hmo and a ppo health insurance plan an hmo health insurance plan gives you access to medical providers and hospitals within the plans network if you visit a.

Doctor or a hospital out of network then your plan is not going to cover the costs unless it's a true emergency as an hmo member you'll have to select a primary care provider who functions as a gatekeeper who will refer you to specialists like a cardiologist or a.

Dermatologist your primary care provider serves as your health care advocate someone who checks to see what medical issues you might have and then refers you to the appropriate care providers an hmo plan might be a good choice for you if you're happy with an hmo network.

Aren't tied to particular doctors outside your network and don't need services when you're out of town hmos also tend to be cheaper than ppos with a ppo insurance plan you have more flexibility in choosing a doctor or a hospital like an hmo a ppo has network providers that are covered under.

The plan's benefits you can also see doctors outside of the ppo network but you'll likely have to pay more for these visits however with a ppo plan you can choose specialists without needing that referral from your primary care provider a ppo plan might be a good option for.

You if you're often outside of your provider's area of medical coverage you'd like flexibility when seeing a specialist or you want to see particular doctors that are outside of your plan's network here are some of the differences between an hmo and a ppo the main difference between an hmo and a.

Ppo is the provider network meaning the group of healthcare providers like doctors pharmacies and hospitals that are covered by your health insurance plan a larger provider network means that you have more options when it comes to choosing a primary care provider or a specialist.

In an hmo your primary care provider is the gatekeeper who decides if you need a specialist you are free to pick up the phone and make an appointment with anyone that you'd like but you should know that an hmo won't cover the cost of that appointment without the seal of approval from your.

Primary care provider and it definitely won't cover the cost of out-of-network care unless it's an emergency hmo plans tend to be more affordable than pto plans to see health plans and prices in your area go to healthsherpa.com
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