How is a PPO different from an HMO?
PPO HMO PPO members are not required to choose a primary care physician. HMO members must choose a primary care physician (PCP). PPO members can refer themselves to specialists. HMO members must get a referral from their PCP in order to see a specialist. PPO members are not required to stay within the PPO network, but there is usually a strong financial incentive to do so. HMOs provide no coverage for care received from non-network physicians. • Who is eligible to enroll in the PPO plans? If you are an employee who works a minimum of 30 hours per week, a teacher, State retiree, or a COBRA participant, you are eligible to enroll in the PPO plans. If you are an NC Health Choice (CHIP) member, you are not eligible to enroll in the PPO plans. Permanent part-time employees who work between 20 and 29 hours per week are also eligible; however, they are responsible for paying the full premium cost. • If I currently have other coverage and choose not to enroll in the PPO during the enrollment p
