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HMO vs PPO: There are many differences between HMO and PPO. A list of differences between HMO and PPO are given below:

No.Comparison Index HMOPPO
1)Stands forHealth Maintenance OrganizationPreferred Provider Organization
2)What it doesIt only covers the subscriber medical expenses within the in-network health provider.It facilitates its subscribers to also visit out of network providers but charges more when the subscribers visit the preferred in-network providers.
3)Premium CostHMO cost may be varied by plan to plan.Most HMOs plans were cheaper than PPOs in past but in recent years, these plans are more expensive than HMO plans.PPOs plan cost may also be varied according to plans. It is expensive than EPO but may be cheaper or costlier than HMO plans according to the situation. It costs more to visit out of network providers.
4)FlexibilityGenerally the HMO models are quite restrictive but it is not true for all models.The flexibilty depends on HMO models. Network based models are more flexible.It is more flexible than HMO plans and partially covers out-of-network care.
5)Plans TypeStaff, Group, Network, Open-pannel.Gatekeeper and Non-gatekeeper.
6)CoverageBasic preventive care like:checkups, Physical emergency, maternity care, surgeries, treatments from specialists. It may or may not cover dental, visual care or abortion.It also covers the same medical facilities like HMO plan.
7)PopularityIt is not as much popular as PPO plan. Consumers are generally prefer to choose PPO plan as compare to HMO plan. But it receives the higher satisfaction rating than PPO plan.PPO plans are always preferred over HMO plans.


HMO and PPO both are the health insurance plans. You should know the difference between them to choose the right plan for your health care needs and budget. There are three types of organizations which provide the different types of plans. These organizations are HMO, PPO, and EPO. Most of the Americans, who have the health insurance plans from their employer or by themselves, are enrolled in the plans either an HMO or PPO.


HMO is an acronym stands for Health Maintenance Organization. It covers all the medical expenses of subscribers when they visit the health providers that are part of the HMO?s network. You must have to enroll in a health maintenance organization (HMO) to get the benefits of medical support. The Health Maintenance Organization facilitates their members to choose their physician from the list of approved health care providers. HMO?s provides the least expensive medical coverage with a minimum amount of paper work. Generally the members of HMO only see the health care specialists (Cardiologist, rheumatologist) when they get referral from their primary care physician. HMO?s provides you best health care advocate and help you find the best treatment for physical and mental health. The HMO?s benefits may be different from company to company and plan to plan. It actually depends on the company and group plan. The HMO covers health screening, cancer screening, preventive care, laboratory tests, X-rays and other scans, prescribed medications, surgical treatments and more. It covers parental care and baby care also. The member should be aware for special benefits offered by your HMO policy and ask if you have any problem and any confusion regarding your plan.


PPO stands for Preferred Provider Organization. It is a managed care health plan that provides its members multiple choices in health care and health care providers. you have to pay a monthly or quarterly premium to get the benefits of PPO. It is more flexible and beneficial than HMO because it provides a large team of physicians to take care of its member and that is the reason its premium is costlier than HMO's policy. PPO has a signed contract to provide care to its plan members at a discounted or negotiated rate. The PPO has a tie-up with the multiple medical facility providers like hospitals, doctors, health care specialists etc. and has a large network to provide better benefits at lower cost.

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