PPOs vs HMOs - Which is better?

December 18, 2019

Do you know the differences between PPOs and HMOs? From the HealthyMarks Education Series, we've put a detailed explanation so you can make the best decision regarding your health insurance decisions.



PPOs are generally more expensive, and provide access to a broader range of doctors… however, that doesn’t make them better or worse than HMOs. Let’s dive into exactly what the differences are.

With an HMO, you have a PCP, this is your go to doctor who dictates your care. He or she will refer you to a specialist. If you see a doctor outside of your HMO network, your plan will not cover any of it… so you must stay in your network with your HMO plan. PPOs are much less restrictive. You do not need a PCP, nor do you need to be referred to specialists. With a PPO plan, you choose the doctors you see. However, if you see a doctor outside of your network, your plan will only cover some of the costs… about half of what they would cover if you were in network.

So which should you select?  If you are generally healthy, and know which doctors you plan to see… I think it is best to select an HMO that is in network with your favorite PCP and specialists.  You’ll get the quality care you are accustomed to at a lower monthly premium.  Now, if your health becomes more complicated… this is a good chance to select a more robust PPO plan to take care of your needs.


So there you go… PPOs and HMOs…  See you next time at the HealthyMarks Education Series.


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Keaton Marks License #0L47187

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