What is the difference between an HMO and a PPO insurance plan? What if my plan is an “indemnity” insurance plan?
In general, an HMO plan requires you to be assigned to a primary care physician. If you would like to see a specialist, you would need a referral from your primary care physician. Referrals that are submitted are reviewed by a medical review subcomittee. For PPO plans, you do not need to have an assigned primary care physician submit a referral to see a specialist. However, your primary care physician can provide you with a “consultation/referral” request so the specialist knows who to contact about your medical care. Many PPO plans have a deductible for medical services, unlike many HMO plans (varies by each individual plan benefits). There are also “in-network” specialists who are contracted with your PPO plan. You can also see an “out-of-network” physician without a referral which will decrease how much your PPO plan covers for medical services rendered.Indemnity insurance plans are neither HMO or PPO plans. Generally, patients with this plan can choose any physician or hospital the
