What is the difference between a PPO and an HMO plan?
Both a Preferred Provider Organization (PPO) plan and a Health Maintenance Organization (HMO) plan use provider networks. Medical providers in both types of plan networks have contracted to provide their services and facilities to plan participants at reduced costs. Participants of a PPO plan have complete freedom in choosing physicians and medical facilities whenever in need of care. If the PPO participant chooses to use a provider outside of the PPO network, there is still insurance coverage available for the services, but the deductibles and co-insurance will be considerably higher than if the services of a network provider had been utilized. In-network providers can be seen for non-surgical office visits for co-payments of $25 to $35. Claims need only be filed for major medical services related to lab, x-ray, surgical, and hospital charges. Calendar year deductibles and co-insurance are out of pocket costs to the participants when major medical services are received. Participants o
