There are two popular medical insurance plans that are available consumers today. These plans are PPO insurance and HMO insurance. In order for consumers to make an informed decision in this matter, they need to understand the difference between the two plans. PPO insurance has several real differences from HMO plans which will be discussed below.
HMO Insurance plans require their policy holders to choose a primary care physician. They then have to see this physician for the bulk of their care. They are also required to obtain referrals or permission from their primary care physician for any testing that is done or prior to seeing any type of specialist. HMO’s also require their policy holders to use their facilities for any medical treatment that is needed.
Policy holders that have this type of plan are able to choose their physician and their treatment facility from a list of preferred providers. The insurance company then rewards the policy holder by paying at a higher rate when they see a physician or receive treatment at a facility on the preferred provider list. Consumers can receive treatment from providers who are not on their lists. However the insurance company will then reimburse the physician or facility at a reduced rate.
The main differences in these plans are HMO insurance consumers are not allowed to choose where they get their medical care done. Cost for consumers at HMO facilities are usually limited to a co-pay. This makes this type of plan more popular with people on a limited budget or a fixed income. Policy holders with PPO plans are allowed to seek treatment at any provider or facility that they choose. PPO plans allow consumers to choose their own providers and facilities. The only difference is the amount of reimbursement that the insurance company offers depending on the provider that is chosen by the consumer. PPO insurance plans seem to be popular with consumers who have more disposable income and want more control as well as choice in their healthcare treatment.