Should i go hmo or ppo

This Primary Care Physician is then responsible for referring you to in-network specialists or hospitals whenever necessary. Members of these networks agree to provide their services at lower prices as negotiated by an insurance company.

Typically, HMOs only contract with a limited number of providers in a geographic area. In exchange for fewer providers, patients in HMOs typically pay lower monthly premiums. There are three types of HMOs. The first type is the staff model or group practice plan. In the staff model, physicians are paid a standard salary regardless of the number of patients they see. Another type is the individual practice association.

Under these plans, physicians earn a fee based on services provided or a fee for every HMO patient, regardless of whether any patient is seen. The last type is an open-ended HMO. This type is a hybrid plan that extends conventional fee-for-service coverage to members.

Those enrolled to receive the benefits of prepaid care in addition to the option of going outside the plan to see another doctor. A majority of the advantages and disadvantages of HMOs are geography based.

But the new tax reform may lead to an expansion of HMOs. According to The Hill , there may be a decentralization of patient services from regional hospitals to local markets. If you would like to keep your doctor, you can determine whether he or she is in-network under an HMO plan, a PPO plan or both. Choosing the right health plan can give you peace of mind, knowing that your insurance plan has your health needs covered.

Get a Quote. Skip Navigation. What is Preventive Care? What Impacts the Cost of Health Insurance? Lower Your Prescription Costs. Log In or Register. Things to consider when choosing between HMO and PPO: To choose the right plan for you and your family, you may want to consider the following: Do you need a lower monthly payment?

Do you stay close to home, or do you travel a lot? If you already have a doctor you like, does the plan you are considering cover visits with him or her? Need an individual and family health insurance plan?

This information can help you if you're shopping for health insurance and want to learn how HMO and PPO plans are different. All these plans use a network of physicians, hospitals and other health care professionals to give you the highest quality care. The difference between them is the way you interact with those networks. With an HMO plan, you pick one primary care physician. All your health care services go through that doctor. That means that you need a referral before you can see any other health care professional, except in an emergency.

Coordinating all your health care through your primary care physician means less paperwork and lower health care costs for everyone.