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HMO Vs. PPO Health Insurance Plan: Which One Should You Choose?

Health insurance is all about having choices.  Most people have several plan choices including HMO and PPO plans.  Health Maintenance Organization (HMO)  and a Preferred Provider Organization (PPO) are two different types of health insurance plans.  The main differences between the two are the size of the plan network and access to out-of-network services.  There are other factors that differentiate the two.

Below is deeper explanation of the differences between HMO and PPO plans:

HMO Health Insurance Plans

HMO plans are known to give access to certain doctors and hospitals within their network.  The network is made up of providers that agree to lower their rates for members of their plan and they also meet quality standards. What makes an HMO plan very different than a PPO plan is that care is only covered if you see a provider within the HMO network.

HMO plans are very restrictive. When you purchase an HMO plan, you are asked to pick a primary care physician that is in your network. All of the care you receive is coordinated by your primary care provider. This means if you want to see a specialist, you will need a referral from your primary care provider. 

HMO’s have cheaper premiums and do not cover out-of-network health care services. 

PPO Health Insurance Plans

PPO plans are pretty flexible. They do allow you to choose an in-network doctor at a lower cost or an out-of-network doctor at a higher cost. 
You do not need a referral from your PCP to see a specialist. PPO plans often come with higher premiums. 

New Jersey health insurance can be hard to navigate.  Cosmo Insurance Agency is located in Bergen and Ocean county.  We travel to you if you can’t make it to us.  Contact Cosmo to set up an appointment today.

Cosmo Insurance Agency is an independent insurance agency serving surrounding communities in New Jersey. Cosmo keeps its promise to assure an efficient and creative approach to the services we offer. Each of our clients experience a personalized and long-term relationship with us. Our New Jersey based team of health brokers guides our clients in helping them choose the most cost-effective options. By incorporating the latest in technology-based tools and laws on healthcare, employee benefits, life insurance and finance, we keep our clients up-to-date with the plans that encompass all of their needs, whether it is individual or group insurance.