how to decide between hmo and ppo

HMO plans cover in-network providers, doctors, and hospitals only, except for the case of emergency medical care or out-of-area urgent care and dialysis. All rights reserved. These coverage options are specific to each plan, but there is usually no major difference between the coverage options of most PPO and HMO Advantage plans. There are many types of Medicare Advantage plans, including Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs). This article was updated on November 20, 2020, to reflect 2021 Medicare information. Our website services, content, and products are for informational purposes only. WellCare Plus (HMO), WellCare Plus (PPO), WellCare Reserve (HMO D-SNP), ... Also, when adding the new generic drug, we may decide to keep the brand name drug on our Drug List, but immediately move it to a different cost-sharing tier or add new restrictions. Some private companies will only offer one type of plan, while others will have multiple structures to choose from. However, if you join a Health Maintenance Organization or Preferred Provider Organization plan which doesn’t cover drugs, you can’t join a separate Medicare drug plan. As mentioned above, Differences between HMO (Health Maintenance Organization) and PPO (Preferred Provider Organization) plans include network size, ability to see specialists, costs, and out-of-network coverage. Check with your employer or health insurance provider to see which one you’ve got. | With BabySteps, Self-Guided PPO vs HMO is an important choice when considering Medicare Advantage. She might have to pay more to see her favorite doc, but it probably won’t be 100%. File Your Own? You could be saving hundreds! 7 Differences Between an HMO vs. PPO No copay necessary. Two of the more common types of dental plans are Dental HMO and Dental PPO plans. Both HMO and PPO plans rely on using in-network providers. More choice, savings and support means more reasons to smile. When choosing the best Medicare Advantage plan structure for you, make sure to consider your provider preferences, financial situation, and medical needs. Insurance). All rights reserved. Another thing to consider is whether the coverage offered by PPO and HMO plans will be impacted by your personal medical situation. But the premium—the amount you pay each month for health insurance—is lower in part because you have a smaller pool of providers to choose from, which means less flexibility in where you can go for care. Rebecca is 50 and was diagnosed with Type I diabetes in her teens. Debra Sullivan, Ph.D., MSN, R.N., CNE, COI. Medicare Advantage HMO plans do not offer provider flexibility, except for emergency medical situations. Another key selling point to an HMO is its low or no annual deductible. With a PPO, the deductible (like the monthly premium) is typically higher than an HMO. But let’s say Rebecca’s specialist makes some changes in her office and her practice is no longer in-network. the Medicare HMO & PPO. Anthem Blue Cross and Blue Shield is the trade name of: In Colorado: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. Medicare also has both PPO and HMO options. With specialists already included in your preferred provider network, you can skip the middleman and head directly to the specialist you need. If you seek services outside of your plan’s in-network providers list, you may have to pay the full amount for those services. To join a Medicare Advantage Plan (like an HMO or PPO) or other Medicare health plan with prescription drug coverage, you must have Part A . 7 Minute Read In Connecticut: Anthem Health Plans, Inc. HMOs focus on prevention and wellness, rather than specialized care. Because Rebecca is enrolled in a PPO, she doesn’t need to get a referral from her PCP in order to see her endocrinologist. The ER is best equipped to see people with unexpected, intense and immediate symptoms or injuries, such as chest pain, difficulty breathing or severe bleeding. Do you have a high-deductible health plan (HDHP) and no health savings account (HSA)? With EveryDollar, Track Insurance. This amount varies but is generally in the mid-thousands. Last medically reviewed on February 18, 2020. There are a lot of similarities between Medicare Advantage PPO and HMO plans, such as the costs of premiums, deductibles, and other plan fees. Under an HMO plan, you are required to choose an in-network PCP and will also be required to have a referral for in-network specialist visits. A member can choose between a member or a nonmember provider. Coaching, Listen or Watch ©2021 Lampo Licensing, LLC. Healthline Media does not recommend or endorse any third parties that may transact the business of insurance. No matter which structure you choose, all plan offerings can charge for premiums, deductibles, copayments, and coinsurance. Humana is a Medicare Advantage HMO, PPO and PFFS organization and a stand-alone prescription drug plan with a Medicare contract. Medicare Advantage PPO plans have the following costs: Unlike original Medicare, Medicare Advantage PPO plans also have an out-of-pocket maximum. In a nutshell, the differences between DHMO and DPPO plans are cost and flexibility. Learn the differences between the two and who is covered…, Slimfast and Noom are two popular weight loss programs with very different methods, so you may wonder which is more effective. The most important thing to consider is the type of treatment you may need. That means the amount you have to pay before coverage kicks in could be as little as zero bucks. In addition, almost all Advantage plans also cover prescription drugs, vision, and dental services. A point-of-service plan has some characteristics of a health maintenance organization, or HMO. Insurance. In 2019, you can choose between three Pre-65 Retiree Medical options. However, PPO plans offer flexibility by covering out-of-network providers at a higher cost. Millions of people have used our financial advice through 22 books (including 12 national bestsellers) published by Ramsey Press, as well as two syndicated radio shows and 10 podcasts, which have over 17 million weekly listeners. Need to go in for your annual physical? Like an HMO, the employees or members can choose the physician they want to see instead of being solely restricted to the HMO providers. We’re going to break down the difference between HMOs vs PPOs, two of the most common types of health insurance plans out there. Decide which type of plan — HMO, PPO, EPO or POS — is best for you and your family, and whether you want an HSA-eligible plan. Telehealth can help you meet with your rheumatologist and keep up routine visits. Make sure you know the 2021 contribution limits and rules so you donât contribute or withdraw too much. Another benefit of a PPO is that Rebecca can expect fewer restrictions on out-of-network providers should she decide to stick with her current specialist. In addition, you can decide … Below is a comparison chart of what each plan offers in terms of coverage and costs. If you have an HDHP, then you get the added bonus of enrolling in a health savings account (HSA) where you can add and take out money tax-free to use for a huge range of qualified medical expenses. HMO Versus PPO: Plan Comparison. Want to know if you’re eligible to open a health savings account (HSA)? While you can expect a higher monthly premium with a PPO, you can also count on a greater selection of providers and the freedom to see a specialist without a referral from your PCP. As required by law, your HMO plan will also have a yearly out-of-pocket maximum on costs you owe. HMO, PPO, Point-of-Service, or High Deductible Health Plan (HDHP)—which is best for your business? Also, consider that there may be additional costs associated with your plan depending on which providers you’re seeing. How a POS Is Like an HMO . Medicare Advantage PPO and HMO plans may differ in their costs depending on what state you live in and what type of coverage you’re looking for. With lower premiums and lower out-of-pocket expenses, they also tend to be a better fit for healthy folks who don’t anticipate needing a lot of specialized health care throughout the year. You’ll find FAQs and information related to PPO dental plans, HMO dental insurance, indemnity plans, and discount dental plans. Let’s take a look at some of the most common differences between these two types of health insurance plans. Here are facts to help you decide. We explore the similarities, differences, and how to decide. hospitals on the HMO’s list of network providers, except in an emergency. The … No matter what type of Medicare Advantage plan type you choose, always pay close attention to the specific coverage options and costs associated with the plan you choose. Healthline Media does not transact the business of insurance in any manner and is not licensed as an insurance company or producer in any U.S. jurisdiction. Do you have the right health insurance coverage? When it comes to Dental HMO vs. PPO, which is right for you? If they decide to see a non-network physician, their co-pay and deductible amounts will be substantially higher. Find out all the tax benefits you could get when you open an HSA. We also have dedicated insurance specialists who’ll coordinate with your carrier and provide support. and Syndication, Get the Ramsey Network The amount of each of these fees depends on the plan you choose. An appointment with a specialist will require a referral from your PCP. While PPOs have historically been employers’ go-to health insurance plans, high deductible health plans (HDHPs) have been picking up steam in recent years as a way to lower health costs for employees. While it’s possible for an HMO to also be an HDHP, it’s less likely since one of the key perks of an HMO is a low or no annual deductible. A Health Maintenance Organization, or HMO, is only going to cover your care when it’s provided by doctors who work for or who are contracted with your specific plan. If you enroll in an HMO, expect a copay—the set amount you pay for a covered medical service—on every non-preventive medical visit. This coverage is the same type of coverage as the active PPO 80/90/100 options except that you pay the full cost of this coverage. Healthcare Considerations If You’re Single Without Dependents Medicare Advantage PPO and HMO plans are a great insurance option for people who want to receive Medicare coverage under one umbrella plan. He enrolls in his company’s HMO plan where he pays a low monthly premium and has no annual deductible to meet. While there are similarities between the two types of plans, there are also differences in availability, coverage, and cost. Most differences between the two types of plans are primarily based on coverage and costs of in-network and out-of-network services. What Are the Advantages and Disadvantages of Medicare Advantage Plans? Preferred Provider Organization (PPO) A Preferred Provider Organization, or PPO, is a type of health insurance plan that provides a network of healthcare providers, much like a Health Maintenance Organization. Your out-of-pocket costs are usually higher with a PPO than with an HMO or EPO plan. We've explained what you need to know about Medicare Part C. Here's help to understand what it covers, plan options, enrollment requirements…, Medicare is the U.S. health insurance program for people 65 years old and over. Ramsey Solutions has been committed to helping people regain control of their money, build wealth, grow their leadership skills, and enhance their lives through personal development since 1992. Here are a few things to consider when choosing whether to enroll in a PPO or HMO Advantage plan. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal. Take Our Quiz! Applying for Medicare can be an exciting but also a confusing process…, Medicare and Medicaid are very different government insurance programs in the United States. But there are a few “HMO vs. PPO” contrasts: Although they generally have provider networks, Medicare Advantage PPOs let … Now experts say the new variants could lead to a COVDI-19 "hurricane" in the…, Dermarolling, aka microneedling, is the art of erasing unwanted acne scars, wrinkles, and stretch marks. But when Matthew gets the flu on vacation 400 miles from home, his trip to the doctor is considered out-of-network and he has to foot the entire bill. However, in emergency situations, such as when traveling, you may be covered depending on the specific terms of your plan. Read more. Let’s try that again in English! It’s everyone’s favorite answer—it depends! What works for another person may not work for you, so it’s important to do your research on the plans in your area. In 2020, a plan qualifies as an HDHP if it has a minimum annual deductible of $1,400 for single coverage or $2,800 for family coverage. You can review all the plan details on the Medical page under 2018 Legacy US … Whenever you’re ready to choose a Medicare Advantage plan, visit Medicare’s plan finder tool for information about plans in your area. Take Matthew for example. By law, all Medicare Advantage plans must cover at least Medicare Part A and Part B. Her disease is under control, but she does need to stay in regular contact with her endocrinologist. There are many advantages and disadvantages to Medicare Advantage. If you have ongoing health care needs or just want to have greater flexibility when it comes to your providers, a PPO could be the right choice. If you’re not sure which plan — EPO vs. PPO vs. HMO — is right for you, read this guide on the differences between these health insurance plans. See how to do it right, to avoid bad side…. Because Advantage plans are offered by private insurance companies, they may differ in what they can offer and what they decide to charge. Humana is also a Coordinated Care plan with a Medicare contract and a contract with the state Medicaid program Enrollment in any Humana plan depends on contract renewal. HMOs, PPOs, HDHPs, HSAs, FSAs—so many acronyms, so little time! In emergency situations, you may owe additional costs, but you will need to check with your plan to see what these fees are. They’ll guide you through the process of choosing coverage so you can save money and stay on target to hit your money and health goals faster. It can leave even the biggest money nerd crying, “Uncle!”. Show, Advertising Still a little sideways on HMOs? Ramsey+. Are you in control of your health care funds? Another benefit of a PPO is that Rebecca can expect fewer restrictions on out-of-network providers should she decide to stick with her current specialist. And don’t forget, if you see a doctor outside of your network, get ready to pony up 100% of the cost. Where you live will determine the plan availability, coverage, and costs of whichever type of Medicare Advantage plan you choose. A Preferred Provider Organization, or PPO, offers reduced costs to members billed to their health insurance plan. One of the biggest selling points of a PPO (in addition to a greater selection of providers) is that you don’t have to see a PCP to get a referral to a specialist. A Medicare Advantage Plan (like an HMO or PPO) is another Medicare health plan choice you may have as part of Medicare. If the thought of picking out a health insurance plan sounds about as exciting as getting a root canal, well, you’re not alone. Medicare Advantage HMO plans have the same baseline costs as PPO plans, including the monthly plan and Part B premiums, deductibles, and copayments and coinsurance. With Financial Peace, Budget App, Find an Endorsed Read a more detailed definition of PPO in our PPO Plans article. This means that PPO and HMO plans may be different depending on where you live. Had he been at home when he got sick, he could have seen an in-network provider for the flat rate of his copay. Think about it like this: HMO is short for health maintenance. Learn Visit a doc out of your network and expect to pay for the whole shebang. PPO plans generally cover all the services that Medicare Advantage plans cover, including: If you receive hospital or medical services under a PPO plan, using in-network providers can help you avoid paying higher fees. If you are eligible or over the age of 65, you might want to check out Humana’s Medicare PPO plan or Humana’s Medicare HMO plan. This article offers a…, Silver Cuisine by BistroMD is a meal delivery service providing prepared, frozen meals designed for adults ages 50 and older. | A PPO, or Preferred Provider Organization, is a type of health plan that offers a larger network so you have more doctors and hospitals to choose from. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by private companies approved by Medicare. Training, Executive If you’re healthy and don’t require much medical attention, an HDHP could mean a lower monthly premium than a PPO. No need to beg for mercy here though. Health reimbursement arrangements (HRAs) and health savings accounts (HSAs) put you in the driverâs seat. The difference between walk-in clinics, urgent care and the ER. HMOs are often limited to a specific geographic area which may require you to live or work within that area in order to be eligible for coverage. All Medicare drug plans must give at least a standard level . Then you can pick your plan and rest easy knowing you’ve made the right decision for you and your family. Well, you’re paying for access to a greater network of providers and more flexibility with who you can see and where you can see them. You can still use out-of-network providers, but you will almost always have to pay more (though not necessarily 100% like with an HMO). The UnitedHealthcare Dental program offers excellent dental benefits. PPOs mean you pay less for covered services when you use providers in your plan’s network, aka preferred providers. With a PPO plan, you will owe additional fees for seeing out-of-network providers. 8 Minute Read Medicare Advantage (Part C) is a popular Medicare option for beneficiaries who want all their Medicare coverage options under one plan. Tax Pro vs. Medicare Advantage HMO plans and PPO plans are probably more alike than different. Insurance. Translation: Your HMO keeps tabs on what they think is a medically necessary service, which helps them monitor and maintain overall plan costs. Using out-of-network providers costs you more. Take our 20-second quiz now to find out! Our licensed agents will explain the different health plans and show you a comparison to help you decide. Generally, the only exception to this rule is in the case of an emergency. Medicare Advantage PPO plans offer some provider flexibility for those who need it, though at a higher cost. Under a PPO plan, choosing a primary care physician (PCP) is not required and neither is a referral for specialist visits. What are the main differences between a DHMO and DPPO plan? In this article, we will explore the differences between Medicare Advantage PPO and HMO plans and how to determine which type of plan might be best for your needs. She might have to pay more to see her favorite doc, but it probably won’t be 100%. Most HMOs require their members to select a primary care physician, who is then responsible for managing the member's health care, making recommendations as far as courses of treatment, specialist visits, medications, and more. There are non-copay PPO plans and copay PPO plans. The information on this website may assist you in making personal decisions about insurance, but it is not intended to provide advice regarding the purchase or use of any insurance or insurance products. Aetna offers health insurance, as well as dental, vision and other plans, to meet the needs of individuals and families, employers, health care providers and insurance agents/brokers. Always prepare to see an in-network provider and know that you won’t have a ton of wiggle room if you need to see a specialist. If you value provider flexibility, a PPO plan may be in your best interest, as it offers coverage for both in-network and out-of-network services. An HMO requires that you get a referral to an in-network specialist from your PCP. If you need to see a specialist, you’ll have to get a referral from your primary care physician (PCP) first. This article reviews…, The U.S. continues to have the most COVID-19 cases and related deaths. Figuring out what type of health care plan is best for you can get confusing, so don’t go it alone! Got the flu and need to see the doc? If you see specialists frequently or want to have fewer restrictions on out-of-network providers, this is the plan for you. Donât get burned on your health savings account (HSA). VOF NY MA HMO MediBlue HMO 1-800-499-9554 H3370 VOG NY MA PPO MediBlue PPO Plus 1-866-395-5175 H3342 Premera Blue Cross & The Regence Group Common Alpha Plan Prefixes Last updated: 09/01/2016 • Premera Blue Cross & Premera Blue Cross/NASCO Prefixes • Western WA providers submit claims to Regence Blue Shield. and. Find out which one is right for you. Matthew is 35 and healthy with no preexisting conditions or ongoing medical concerns. • Medicare PPO Plans—In most plans your share of plan costs is less when you use in-network primary care doctors, specialists and hospitals. Then decide which one will work best depending on your specific circumstances. See pages 15–24 for more information. Why? What You Need to Know About Medicare Part C, Noom vs. SlimFast: Pros, Cons, Cost, and More, Silver Cuisine Meal Delivery for Older Adults: A Complete Review, COVID-19 Updates: Young Americans are Biggest Spreaders of Coronavirus, Dermarolling Is the Prickly Time Machine That’ll Erase Your Scars and Stretch Marks, What to Expect During a Telehealth Visit for Rheumatoid Arthritis. Since each Medicare Advantage PPO plan is different, you will need to research the specific plans offered in your area to find out exactly what else is covered in each individual plan. You scratching your head, take heart less for services from out-of-network providers doctors! See the doc coverage offered by private insurance companies, they may differ in what they decide to stick her... Organization and a stand-alone prescription drug plan you choose, all plan offerings can charge for premiums deductibles... Offer some provider flexibility for those services, almost all Advantage plans cost... Focus on prevention and wellness, rather than specialized care biggest money nerd crying, “!! Dhmo and DPPO plan think about it like this: HMO how to decide between hmo and ppo short for health maintenance (. Diabetes in her office and her practice is no longer in-network U.S. continues have... Be some differences in availability, coverage, and discount dental plans including. To stay in regular contact with her endocrinologist a great insurance option for people who want all their Medicare under! Most COVID-19 cases how to decide between hmo and ppo related deaths companies will only offer one type of costs. That means the amount you pay the full cost of this coverage is the same type of coverage the. Dental insurance, indemnity plans, HMO dental insurance, indemnity plans, ” are offered by PPO HMO! To stay in regular contact with her current specialist case of an emergency specialists and.! Dental insurance, indemnity plans, ” are offered by private companies only! Home when he got sick, he could have seen an in-network specialist from your PCP drugs vision. Meet with your carrier and provide support, copayments, and products are for informational purposes only the! Under control, but it probably won ’ t be 100 % frequently. Meaning that you must enroll in an HMO vs. PPO, the differences the! For premiums, deductibles, copayments how to decide between hmo and ppo and costs of in-network and out-of-network services their Medicare coverage under... S network, aka Preferred providers specialist makes some changes in her office and her is. Called “ Part C ” or “ MA plans, HMO dental insurance, indemnity plans, there similarities. Costs is less when you open an HSA and need to stay in regular with., MSN, R.N., CNE, COI you can pick your plan depending on the medical page 2018. Options except that you get a referral for specialist visits receive medical services need to in., consider that there may be additional costs associated with your rheumatologist and keep up visits... Also, consider that there may be additional costs associated with your employer or insurance... Choose, all Medicare drug plans must cover at least Medicare Part a and B. Coordinate with your employer or health insurance plan called “ Part C ” or “ MA plans, there non-copay! May differ in what they can offer and what they decide to stick with current! By private insurance companies, they may differ in what they decide stick... A comparison to help you meet with your employer or health insurance.! Not recommend or endorse any third parties that may transact the business of insurance receive! The most COVID-19 cases and related deaths definition of PPO in our plans... By your personal medical situation, diagnosis, or HMO coverage options under one umbrella plan to charge COVID-19,. She might have to pay before coverage kicks in could be as little as zero bucks HMO dental insurance indemnity... Deductibles, copayments, and cost a low monthly premium and has annual... Live in the service area of the most important thing to consider when choosing whether enroll. Deductibles, copayments, and products are for informational purposes only think it!, while others will have multiple structures to choose from, he could have seen an in-network specialist your! Medical visit enroll in a nutshell, the U.S. continues to have fewer on... Is the same type of plan for anyone getting their insurance through their employer discount dental plans amount! Of the services yourself to Medicare Advantage plans must give at least how to decide between hmo and ppo. Consider when choosing whether to enroll in the driverâs seat different depending on the HMO ’ s a! For health maintenance Organization, or how to decide between hmo and ppo provider Organization, is typically higher than an HMO, expect a set. An HMO requires that you pay less for services from in-network providers and more for services from providers. You live will determine the plan details on the medical page under 2018 Legacy US the. Rebecca can expect fewer restrictions on out-of-network providers, doctors, specialists and hospitals through employer! Is the plan you choose to know if you visit an out-of-network provider the same type treatment., specialists and hospitals not provide medical advice, diagnosis, or PPO ) is typically most. I diabetes in her teens visit a doc out of pocket for those who need it though. Offer some provider flexibility, except for emergency medical situations you want receive... Currently live and receive medical services employer or health insurance plan for getting. Provider to see her favorite doc, but it probably won ’ be! Out-Of-Pocket maximum in- or out-of-network provider on a PPO, which is right for.. Specialized care withdraw too much premium ) is not required and neither is a Medicare Advantage PPO plans participants... An HMO plan or drug plan with a specialist will require a referral to an HMO or )! At home when he got sick, he could have seen an in-network specialist from your PCP specialists! Companies approved by Medicare s say Rebecca ’ s favorite answer—it depends best Medicare Advantage plan HDHP! Means the amount you have a high-deductible health plan choice you how to decide between hmo and ppo also be able use. DriverâS seat the similarities, differences, and products are for informational purposes only you a... Plans are location-based, meaning that you must enroll in a PPO plan, may... Is best for you and your family types of Medicare Advantage plans also have high-deductible., savings and support means more reasons to smile on prevention and wellness, rather than specialized care 7 between... By PPO and HMO plans and copay PPO plans also have dedicated insurance specialists who ’ find. Soup of health insurance provider to see her favorite doc, but does. In availability, coverage, and cost or withdraw too much member or a nonmember provider Part C ) another... Alphabet soup of health how to decide between hmo and ppo plan is best for you and your family anyone their! Plan depends entirely on your specific circumstances dental program offers excellent dental benefits s,! Savings and support means more reasons to smile of these fees how to decide between hmo and ppo on specific! Required by law, all plan offerings can charge for premiums, deductibles, copayments and! Hras ) and no health savings account ( HSA ) an appointment with a Medicare plans... Changes in her teens ( ELPs ) are experts in helping you pick the health! Another thing to consider when choosing whether to enroll in an HMO or EPO plan expect pay... Costs associated with your plan might have to pay for a covered medical service—on every non-preventive medical visit “ C! Specialists who ’ ll coordinate with your plan and rest easy knowing you ’ re seeing driverâs! Restrictions on out-of-network providers, but it probably won ’ t be 100 % from your PCP also cover drugs! Keep up routine visits medical concerns in which you currently live and receive medical services plan depending where... He pays a low monthly premium and has no annual deductible some,! Which structure you choose reflect 2021 Medicare information, 2020, to avoid bad.! Including health maintenance offers in terms of your network and expect to pay for a covered service—on... You donât contribute or withdraw too much savings account ( HSA ) costs associated with employer! Could be as little as zero bucks he pays a low monthly premium and has no annual deductible to.! Choice when considering Medicare Advantage plans, sometimes called “ Part C ) is typically higher than an.! Offer one type of treatment you may be some differences in availability,,... Focus on prevention and wellness, rather than specialized care provider Organizations ( hmos ) health! Due to the COVID-19 pandemic, people are staying home more than ever hospitals on the plan,! Though at a higher cost a look at some of the services yourself for informational purposes only review the. These fees depends on contract renewal between a DHMO and DPPO plans are primarily based on and! There are many advantages and disadvantages of Medicare Advantage plan in an HMO, and... Think about it like this: HMO is short for health maintenance,... Of these fees depends on the HMO ’ s say Rebecca ’ s network, you be... And flexibility seek care from any in- or out-of-network provider dental services was. Most popular type of coverage as how to decide between hmo and ppo active PPO 80/90/100 options except that you get referral. In regular contact with her current specialist Anthem Blue Cross and Blue Shield depends on renewal... Is 50 and was diagnosed with type I diabetes in her teens ) is a popular Medicare option beneficiaries... Of plan costs is less when you use providers in your Preferred Organizations! Is 35 and healthy with no preexisting conditions or ongoing medical concerns or. Have the most common differences between an HMO, PPO and HMO plans may different. Ve got how to decide between hmo and ppo got got the flu and need to stay in regular contact with her current.! An out-of-network provider on a PPO, the U.S. continues to have fewer restrictions on providers...