What is the difference between an HMO and a PPO?

Asked 6 months ago
An HMO (Health Maintenance Organization) and a PPO (Preferred Provider Organization) are two types of healthcare insurance plans that differ in terms of flexibility and cost. With an HMO, you must choose a primary care physician (PCP) who will coordinate all of your medical care and referrals to specialists. You can only see providers within the HMO network, and typically need a referral to see a specialist. HMOs generally have lower premiums and out-of-pocket costs, but less choice in providers. On the other hand, a PPO provides more freedom to see any healthcare provider you choose, including specialists, without a referral. While PPO plans have higher premiums and deductibles, they often offer more coverage for out-of-network services. PPO plans are suitable for individuals who value flexibility and want the ability to seek care from a broader range of providers.
Adam Goldkamp is the editor / author responsible for this content.
Answered Nov 1, 2023

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