What is the difference between an HMO, a PPO and a POS?
• Most HMOs (health maintenance organizations) have lower out-of-pocket expenses when members use the HMO’s preferred providers and facilities. If members go outside of the network, they generally have higher out-of-pocket expenses and may be responsible for paying the entire bill. • In addition, members must choose a primary care physician and see that person first whenever they need medical attention. The primary care physician will make necessary referrals to specialists. • With HMOs, the per-visit or annual deductibles are usually lower than with other plans. • Most PPOs (preferred provider organizations) charge members slightly more than HMOs to use providers and facilities outside of the PPO network and do not require referrals to see specialists. • PPOs are generally more flexible than HMOs but tend to cost members slightly more. The per visit or annual deductibles are usually higher than with HMO plans. • POS (point of service) plans are a combination of the features of HMOs an
