What is the difference between an HMO and PPO?
HMO stands for Health Maintenance Organization. An HMO is a group that contracts with medical facilities, physicians, employers and occasionally individual patients to provide medical care to a group of individuals. HMO plans tend to be very restrictive and have many rules. You must select a primary care physician (PCP) who is under contract with the HMO. The PCP manages all aspects of your healthcare. PPO stands for Preferred Provider Organization. If you choose a doctor not under contract, you pay more. Like an HMO, you usually pay a small amount known as a co-pay each time you visit your PCP or health-care facility. Unlike an HMO, if you choose to see a doctor who is not contracted with the PPO, the plan might pay a percentage of the medical bills (out-of-network benefits). However, your cost will probably be higher than if you choose a caregiver that is in the plan’s network.
