HMO vs PPO: It’s the ABC’s of Health Insurance

HMO vs PPO: It’s the ABC’s of Health Insurance

When looking for health insurance, there are two common terms that are shown next to the various plans. While you may of heard of them, do you really know what they mean?

We at Florida Healthcare Insurance feel your frustration and are here to help.

Before we help though, we should tell you what each of these letters stand for:

HMO stands for Health Maintenance Organization, and the coverage restricts patients to a particular group of physicians called a network.

PPO is an abbreviation for Preferred Provider Organization and allows patients to choose any physician they wish, either inside or outside of their network.

So now that we know what each translates to what are the big differences between the plans. Here are a few examples:

  • Patients in with an HMO must always first see their primary care physician (PCP). If your PCP can’t treat the problem, they will refer you to an in-network specialist. In contrast, with a PPO plan, you can skip the middle man and see a specialist without a referral.
  • With an HMO plan, you must stay within your network of providers to receive coverage. Under a PPO plan, patients still have a network of providers, but they aren’t restricted to seeing just those physicians. You have much more freedom to visit any healthcare provider you wish without having to pay out of pocket. If you have an HMO and go outside of your network for a specific doctor or service your network coverage will either disappear or greatly be reduced.

Essentially a PPO gives you and your family more flexibility when it comes to doctors and healthcare facilities. It does though usually come with a more expensive premium.

Don’t go through making this decision on your own. We can help consult with you all along the way to make sure you are making this important decision for you and your family.  Learn more by calling 954-282-6891 or visiting

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