| In America the cost of health care is on the | | | | will cover all expenses associated with their |
| rise with no sign of becoming any cheaper in | | | | treatment. The two managed care plans differ |
| the near future. One way of combating this is | | | | when it comes time to receive treatment |
| with the use of health insurance. There are | | | | outside of the network. HMO members will not |
| many types of health insurance available but | | | | receive coverage or benefits if they decide |
| one of the most popular types is managed | | | | to get medical care outside of the private |
| care. This article will examine two managed | | | | network. If they do insist on doing so they |
| care plans PPO and HMOs and will compare and | | | | will have to pay out of their own pocket. |
| contrast to see the differences and | | | | Members of the PPO can go outside of the |
| similarities between the two. | | | | network to receive care; however the coverage |
| | | | benefits would be substantially less. To |
| HMOs and PPOs are similar in the fact that | | | | entice members to stay and receive coverage |
| the two of them members need to choose a | | | | in network, the PPO often times gives |
| primary care physician (PCP). The PCP is | | | | financial benefits which will encourage their |
| responsible for the majority of the medical | | | | members to stay within the network. |
| care for the members of the medical plan. If | | | | |
| any member needs to see a specialist, then | | | | In closing the choice of the best managed |
| the PCP has to be consulted and offer a | | | | care plan for you rests on the individual. |
| reference before the specialist can be seen. | | | | Both the HMO and PPO have their advantages |
| It is with the PCP aspect that the HMO and | | | | and disadvantages. Depending on what is the |
| PCP differ. As stated it is necessary for | | | | best choice that fits the individual's |
| member of the HMO to have a PCP, this is not | | | | lifestyle, then they should proceed with |
| true for members of the PPO. The members of | | | | managed care plan. HMO is a much more |
| the PPO can choose a PCP if they please but | | | | restrictive and you do not have the |
| they are not required to. This also means | | | | flexibility in your choices. You do what is |
| that the members of the PPO can refer | | | | laid out to you and if you go outside of |
| themselves to a specialist of their choice. | | | | their network you will not receive any |
| | | | benefits. The PPO allows you some amount of |
| When members sign up for the different | | | | flexibility but the financial rewards are |
| managed health care plans, HMO & PPO there | | | | diminished. You are not tied to a network |
| are usually different stipulations associated | | | | like the PPO and this increase the options |
| with both. One such stipulation is in regards | | | | that you have. As stated the difference |
| to medical coverage. Both HMO and PPO members | | | | between an HMO and PPO is all a personal |
| are covered once they seek or receive medical | | | | choice and it will depend on what the person |
| care within the private network. The plan | | | | wants out of the plan. |