HMO is an abbreviation for Health Maintenance Organization. PPO is an abbreviation for Preferred Provider Organization. Even though these terms are both acronyms, their coverages are very different! The main differences when enrolling in an HMO Plan:
- HMO plans require you to establish a Primary Care Physician from their doctors list.
- HMO plans require you to receive a referral from your Primary Care Physician before seeing a Specialist.
- There are no out-of-network benefits on HMO plans; however, out of network benefits on a PPO are nothing to brag about either.
PPO plans will give you access to more doctors which will decrease wait times when trying to use the policy. You will also avoid the referral requirement on a PPO plan which will give you direct access to specialists whenever you need to see one. Simply put, a PPO plan will give you more flexibility and freedom when receiving health care. Because of this extra coverage, PPO plans usually cost about 15% more in monthly premiums.