Insurance companies in conjunction with hospital have greatly innovated their covers with more dynamic and subtle plans for the insured. Some of the health plans ubiquitously known include the Health Maintenance Organization and the PROFFERED PROVIDER ORGANIZATION plans. HMO is a group of medical practitioners, health care professionals or hospitals providing services at a cheaper cost while PPO consist of group of healthcare providers that provide services that can be reimbursed on a discounted model by the bearers. The two plans are usually confusing for most simply because they have a very fine line on their differences. However, when it comes to selecting which health plan is the best for you consider the following key differences:
A HMO healthcare plan provides your Primary Care physician with the role of organizing all the requirements for you for instance monthly checkups while a PPO healthcare plan, there is no need to be having your preferred Primary Care Physician to organize all the services you may need, implying you can have any Primary Care Physician of your choice. However with this plan it gets cheaper when you select the type of doctor you may need.
A HMO healthcare plan also allows you to first have recommendation from a Primary Care Physician before seeing a specialist while a PPO healthcare plan gives you the preference of seeing a specialist directly without having to go through a Primary Care Physician whereas a HMO plan does not provide you with the cover at a hospital facility which is out of the network or seek a Physician out of the HMO plan network unless you have suffered an emergency and need quick attention.
A HMO healthcare plan is much cheaper than a PPO plan. This is because of low premiums for subscription which are paid for every month. With this plan you spend less cost on any medical services provided which is typically charged from your pocket. This plan is also subsidized through co-insurance and sharing between hospital facilities. In contrast, a PPO health plan is more costly from its monthly premiums all the way to providing you with the flexibility when selecting your preferred Primary Care Physician. Also, costs increase when the plan provides you with the preference of seeing a specialist directly without any referral from a Primary Care Physician. Also any other medical services not included in the plan can be costly especially since they are on your pocket.
With a HMO healthcare plan your protected from filing any claim in case of any problems encountered on service delivery or dissatisfaction on the insured because the insurance companies pay on your behalf whereas in a PPO healthcare plan, you will likely be involved in filing any claims for compensation since you have to pay the health practitioners directly especially when you access medical services from a health practitioner who is not within the network provider.
Both health plans are good for you depending on your preference However, PPO offers flexibility than a HMO healthcare plan.