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