What is the difference between a Medicare HMO and PPO plan? Well an HMO stands for Health Maintenance Organization and PPO stands for Preferred Provider Organization. Let’s go over some of the major differences between these two plans.
HMO :
- You will need to choose a primary care doctor
- If you need to see a specialist, you will need to go to your primary care doctor first to get a referral.
- Generally will have co pays for your doctor visits and services you use
- You will need to use the network of hospitals and doctors to obtain your medical care. If you choose to go outside of that network, your HMO plan may not cover the costs of your visit.
- Tends to be more affordable with lower premiums and deductibles
PPO:
- You do not need to choose a primary care doctor.
- You may see a specialist without the need of a referral from your primary care doctor
- May likely also have co pays for doctors visits and other services.
- You may see any doctor within the insurance company’s network without need of a referral.
- Will likely have an annual deductible and larger premiums
- Can generally see doctors and obtain services out of network, though you will likely pay for more of the cost of the services compared to in-network doctors and hospitals.
It is important to understand what your current healthcare needs are, as well as, what your future costs may be to help decide which type of plan may be right for you. If you choose an HMO, you will need to make certain that your list of doctors are included in that HMO plan.
You will have choices to make when it comes to choosing the type of Medicare plan that is right for you. To help make sure you are choosing the right plan for you, contact me so we can go over your options and help you make the best decision. As always, there is no cost to sit down and discuss your options.