What are the differences between PPOs and HMOs?

Hi i'm keaton this is the healthy marks education series PP o–'s are generally more expensive and provide a broader access to doctors however that doesn't make them better or worse than an HMO so let's dive in to exactly what the differences are with an HMO you've got a primary care physician this is your go-to doctor and they're gonna refer you.

To any specialist so if you see a doctor outside of your HMO Network you're gonna have to cover all the costs to yourself your plan doesn't cover anything PPO plans are much less restrictive you do not need a primary care physician nor do you need to be referred to specialists you get to choose the doctors that you want to see however if you see a doctor.

Outside of your network you're only going to be covered for about half the benefits rather than full benefits if you went to a doctor in network out-of-network benefits are great but this is where PP o–'s can get really tricky let's say you call a doctor's office and say hey do you accept my insurance yes they may say even though.

They're gonna only offer you out-of-network benefits I would rephrase the question and say is my plan in network with your doctor's office HMO plans keeps the process of selecting doctors simple some plans and providers are all encapsulated into one company Kaiser is a great example of this with a Kaiser plan you're gonna go to Kaiser.

Facilities and see Kaiser doctors HMO plans provided by anthem or United Healthcare do things a little differently they gather a group of doctors and facilities local to you and create a network out of that so for example here in North County a Blue Shield at Rio HMO plan will provide you access to Scripps network so which.

Should you select if you're generally healthy you may want to select an HMO plan that provides you with access to the doctors and facilities that you're generally accustomed to you'll be paying a lot less money each month for this HMO plan compared to a PPO plan now if your health becomes a little bit more complicated this may be a good.

Opportunity for you to select a more robust PPO plan one that provides more access to doctors so there you have it PPOs and HMOs thanks for joining us here at the healthy Mark's education series
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