Health Plan of Nevada’s HMO Plans vs. PPO Plans

Health Plan of Nevada is owned by United HealthCare. They offer HMO options to individuals as well as businesses with small group health insurance plans. Unlike their sister company, Sierra Health and Life, Health Plan of Nevada only offers HMO plans. HMO stands for Health Maintenance Organization. Currently, Health Plan of Nevada’s plans requires members to get a referral from a Primary Care Physician before seeing a Specialist. This is a common requirement with most HMO insurance companies across the nation.

Members have access to a network of doctors, facilities, and pharmacies in their service area. Outside of the service area, members will not have coverage on their HMO plan. Traditionally, Health Plan of Nevada has established their 2 primary service areas as Southern Nevada and Northern Nevada.


What is the difference between HMO and PPO? HMO plans usually have lower monthly premiums compared to PPO plans. This is because PPO plans usually have larger network lists. PPO plans also allow consumers to see a Specialist without a referral from a Primary Care Physician. Lastly, PPO plans cover out of network services whereas HMO plans do not. These added benefits can aid consumers who travel throughout the state of Nevada a lot. Consumers who need quick access to medical professionals will also benefit from the no referral requirement on PPO plans. Hometown Health Plan, a local company in Nevada, is currently the only carrier to offer PPO plans to Individuals and Families. For health insurance small business plans, there are many insurance companies in the state of Nevada who offer PPO plans.

When to buy HMO

HMO plans are a great tool for consumers who do not travel much and need a lower costing health plan. People who are healthy and do not need a large network list can easily find doctors and facilities on an HMO network for basic and routine needs. Understanding the differences between HMO and PPO is important when shopping for coverage. If you need help understanding which option is the best fit for you, give us a call today a licensed health insurance broker will help you.