What is the difference between HMO and PPO coverage?
A. The level of benefits (i.e., generosity of coverage, deductible and co pays), and the amount of freedom to choose among physicians and hospitals are usually the two main differences. See below . . . HMO: A Health Maintenance Organization provides benefits for preventive care coverage and low out-of-pocket costs. There is typically no coverage for care from doctors or hospitals outside your HMO. Plans usually offer comprehensive benefits and affordable premiums with no deductibles. You choose a Primary Care Physician from a network; This Doctor oversees all your care, and may provide referrals to specialist if needed. PPO: A Preferred Provider Organization is a network of physicians and hospitals that have agreed, by contract, to discount their rates to members. The networks are typically very large, and the members are free to seek care from any physician or provider within the network, including specialists without a referral. Members may also access non-contracted providers, but a
