What is the difference between HMO & PPO?
A Health Maintenance Organization (HMO) requires members to select a primary care physician (PCP) and obtain specialist referrals, only covering medical care rendered by doctors within an approved, tightly managed network. In contrast, a Preferred Provider Organization (PPO) offers significantly greater flexibility, allowing members to visit any healthcare specialist or out-of-network provider without requiring referrals, though staying within the preferred provider network yields lower out-of-pocket costs. HMO plans typically feature lower monthly premiums and deductibles, whereas PPO plans trade higher premiums for broader clinical freedom and out-of-network coverage options.
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