If you are considering buying individual health insurance, HMO and PPO are two things that you should research about before shopping around for it. These two have very important differences, but they also provide almost the same services, and both focus on health insurance. HMO and PPO will most likely be terms that you will come across when you look around and are in the market for individual health insurance, and knowing the difference between the two will be useful and will be a great factor in choosing the right type of insurance for you when you hit the market for health insurance.
So what are HMO and PPO? We will start with the former. HMO stands for Health Maintenance Organization. A health maintenance organization will require you to choose a primary health care provider. In other words, you will have to choose which doctor you prefer because that doctor will be the only one you can go to and avail of your health insurance at the same time. This will mostly be determined by your doctor, if you have a specific go-to one, and if they are signed up to an HMO instead of a PPO. HMO is ideal for those who see specialist doctors or general practitioners, as most of them are signed up to an HMO contract.
PPO, on the other hand, if you are considering buying individual health insurance under a PPO, it will cover a wider range of health care provider services. As opposed to HMO, PPO will not restrict you to a primary health care provider. As long as the doctor is signed up to a PPO contract, you can avail of this doctor’s health care services. PPO, or Preferred Provider Organization, also offers a wider range of health care services that HMO might not provide. On top of that, PPO as a third party organization makes health care providers charge at reduced rates to its clients.
HMO generally gets bad press for its restrictive rules and services provided. People buying individual health insurance opt for PPO instead of HMO. But PPO proves to be significantly more expensive despite its reduced rates, as it has a wider range of coverage for their clients. HMO is more for you if you need to see a doctor for only a certain amount of health care services, such as illnesses that are chronic and need regular check-ups and special services. PPO will prove more useful if you anticipate emergencies instead of regular doctor visits, and will offer more flexibility in its coverage than HMO can offer.
In the end, choosing individual insurance would depend solely upon your health care needs. Purchasing individual insurance will guarantee that you never get caught empty handed, but availing of the wrong type would still leave you with that problem, as HMO and PPO are two different contracts and your health care provider might be signed up to either one of these. Buying individual health insurance wisely by doing all the necessary research and knowing what its coverage is will prove to be very useful in cases when you need health care the most.