What is the main difference between an HMO and a PPO?
Most HMOs require you to select a specific doctor as your primary care physician, or PCP. This doctor is supposed to be your first “port-of-call” for most any medical condition, although exceptions are typically made for emergencies. As such, he or she will end up providing most of your medical care. Your choice of specialists and hospitals is usually limited to those already under contract with the HMO, and your primary care physician is the one who decides whether or not a referral to a specialist is actually necessary. One major benefit of an HMO is that maternity is a covered expense. PPOs combine some of the characteristics of HMOs with the flexibility of traditional fee-for-service plans. PPOs offer a specific set of doctors and hospitals that the member can choose from to get discounted rates. These are called “preferred” or “in-network” providers. PPO members are free to see any in-network provider at any time. Members can also see doctors who are not in the network, but the co
