PPO Vs. HMO: What’s the Difference and Which is Better?

Do you know the difference between a PPO and an HMO is do you know which one is better well hey that's we're going to find out today how's it going everybody I'm Joey Cheng all the with Chen Golan Insurance and today we're going to settle the debate on over through the debate but we're going to settle it anyways of PPO versus.

HMO what do you need to know which one's better what should you buy well let's get into that right now so if you want to know the answer to which is better you need to ask yourself a question first and the question that you need to ask yourself is is do you want to see more or less doctors once you have the answer to that question then you can.

Decide if the HMO is right or the PPO is right at first well let's back up what does PPO actually mean well the letter's PPO stand for preferred provider organization this plan is going to offer a higher reimbursement level for the treatment you receive from that preferred doctor if I were to say that in less fancy insurance terms you're.

Just going to pay less basically you might also hear this preferred provider organization referred to as your insurance companies network of doctors and hospitals again these preferred doctors are going to offer their services to you at a discounted rate because that health insurance company is telling you that you can go see them.

You're also going to have the option to see non-preferred doctors as well again you're just gonna have to pay a little bit more if you stray outside of that network of doctors that's most commonly known as you're out of network coverage and to be honest for the last 10 to 15 years PP o–'s have dominated the bulk of what's been available from your.

Health insurance companies so what does HMO stand for then HMO stands for health maintenance organization and they're making a comeback faster than and I have a pop culture reference I have two little kids I know nothing about what's going on in the world outside world I don't have insert your own joke what's making a fast comeback somebody tell me.

This HMO plan is going to work a little bit differently than that PPO plan instead of choosing from a list of doctors you're only going to be able to go to those specific doctors and hospitals that have an agreement with that insurance company the goal of this plan structure is to have a primary doctor kind of manage and direct your.

Care basically quarterback the thing and kind of tell you what you need to do when and where and who to go see so the most famous example of this HMO structure is the company that is now called healthspan or formerly known as Kaiser Permanente the catch here with these HMO plans is that.

Generally less expensive than a PPO plan however again that is an exchange for a limited selection of providers but not so fast let's go and take a closer look at this thing someone actually that questioning it how many doctors and hospitals do you want to be able to go to if something really bad happens the answer to that again will settle your.

PPO and HMO debate that you're having with yourself but if we want to go even deeper here's what you have to think about when does an HMO plan makes sense it's an obvious question and it's really a hard one to answer since it's going to determine on your personal preference but this is how I usually explain it to clients if you have an HMO plan.

Available to you that has doctors and hospitals within close proximity of where you live and those doctors and hospitals also happen to be of a quality and a standard that you want to receive treatment from yeah that's a decent first step but you also need to be able to save a decent amount of money every month from the health insurance policy.

As well finding both of these things together is really the tricky part personally I have yet to come across an HMO plan that offers enough savings to make that justification we only saving a handful of dollars every month you have to ask yourself if it's really worth the trade-off so why is a PPO so great then well that's a very honest question like.

I mentioned above the PPO is going to give you the ability to not just go see the doctors within your network but also any other doctor that you need to it'll just fall under that out of network benefit of course you will be paying more to see those out-of-network doctors however it is better to have them covered under your plan at a lower.

Percentage than not covered at all so what's the bottom line HMOs really need to widen the price gap from PPO is to really be considered a serious contender in my opinion until they do PP o–'s are still going to dominate as far as I'm concerned what should be at the center of your health insurance plan really the trickiest.

Thing about this is spotting the difference in the first place again outside of three subtle letters that are listed next to plan type on the summary of benefits that you're looking at there really isn't much else to indicate that you know you're looking at an HMO plan versus a PPO plan and you could actually buy one by mistake that's not to also.

Insinuate that PPO plans are without blame here because there are even some PPO networks that I would recommend that you probably want to stay away from the doctors and hospitals that you have access to is one if not the most important things your health insurance does for you so what's the next step we'll go ahead click right.

Here on my face and we're going to actually put the HMO and PPO s to a test so you can see the actual price difference for yourself and if that math actually makes sense so go ahead click again right here on my face or if not there is a link below in the video's description to get started with that right now of course I do appreciate.

You taking the time to watch this video and as always I am Joey jingle the with jingle insurance take it easy everybody

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