Which hmo to choose

HMO plans. Which one is right for me? How can I choose or change my primary care physician? Health Insurance HMO vs. PPO - Which one's for you? Was this content helpful? Give Feedback. This handy guide will help you understand the key differences between PPO and HMO plans and how to make the right choice for you. HMO pricing is set you pay only your co-pay for covered services , but there are a few restrictions; you must see a provider who is in your network, and you must select a primary care provider PCP.

PPOs offer greater freedom in that you can see providers out of network, but pricing can fluctuate dramatically depending on a variety of variables, including who you see, whether the visit applies to your deductible, and whether the provider you see is in network.

HMOs require that you designate one PCP with your insurance who is responsible for managing and coordinating your health care. PPO plans offer greater flexibility in this regard because you can book appointments with providers who are in the PPO network as well as providers who are out of network although you may pay a higher rate if you choose the latter.

While the freedom of a PPO plan may sound appealing, keep in mind that PCPs play a valuable role in helping you evaluate the best plan of action for your health goals. In addition to evaluating treatment options, your PCP can help you avoid expensive and unnecessary tests and procedures that a specialist might otherwise order for you. Most PPO plans allow you to see a provider outside of your home region with little to no interruption in coverage.

HMO plans typically limit where you can be seen, although you may have emergency care benefits in other cities. When you need lab work done, you can choose the most convenient location under a PPO network. If you need a lower monthly fee, consider an HMO plan. If you travel frequently and are more likely to need care while away from home, especially if you are living with a chronic condition, or enjoy high-risk hobbies such as certain sports, you may need a PPO to provide the best coverage for your needs.

If you need a lot of specialist care, say you are managing a rare or chronic condition, you may also prefer the ease of choosing specialists and seeing them right away that you get with a HMO plan. If you mostly get care in your home city or mostly from your family physician, an HMO is more likely to provide the right coverage for you.

If you would like to keep your doctor, you can determine whether he or she is in-network under an HMO plan, a PPO plan or both. Choosing the right health plan can give you peace of mind, knowing that your insurance plan has your health needs covered.

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