What’s better, a PPO or HMO?

UPDATED: May 16, 2011

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UPDATED: May 16, 2011Fact Checked

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Asked May 16, 2011

1 Answer

In general, an HMO is more restrictive for the patient than a PPO, requiring all treatment to be done inside the network. On the other hand, an HM tends to be less costly than a PPO, because the patient does not pay as many fees such as copays and deductibles. If your primary concern in monetary, the HMO is probably a better selection. But keep in mind that any procedures you require outside of the HMO network are probably going to be out of pocket expenses.

A PPO, on the other hand, is more flexible than an HMO. The PPO has a network of health care providers the same as an HMO, but it also allows you to seek care outside of the network. Such out-of-network procedures may only be paid up to the amount that would have been paid for the same procedure in the network, which means that you will be responsible for any costs over the network agreed costs. Where the level and flexibility of care available is more important than budgetary constraints, a PPO is probably the better choice for a health care plan.

Which one is the best for your needs will depend on a number of personal factors, but the cost difference may be helpful in making a decision. Because of deductibles and higher copays, a PPO is usually the most expensive type, where HMO plans are more widely affordable.

Answered May 16, 2011 by Anonymous

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