What type of insurance is better PPO or HMO?

5 Comments

1. nancy_garcia says:

   August 12, 2009 at 3:12 am

   I hate HMO yea the copays are cheaper but it takes longer to get aproval on services and PPO for me has worked better the copays are just a little higher but the insurace I believe is better
2. Peacemaker says:

   August 12, 2009 at 3:12 am

   Get HMO. and sign up to get Kaiser Permanente. The co-pay is really low and all the services your dad will need are under one roof
3. Trudy says:

   August 12, 2009 at 3:12 am

   HMO’s can be more of a hassle than PPO’s and you’ll likely find PPO type of coverage more affordable in the individual market.

   The bigger concern is his pre existing condition. If your dad was laid off, you best bet will be to take advantage of the reduced COBRA benefit as long as you can. If not and he had insurance in the last 18 months (without greater than a 63 day gap} than he can take advantage of HIPAA coverage which will cover his condition, but may be a bit more expensive. Otherwise you may find your options very limited.

   I wish you and your father well. Let me know if I can help you further.
4. Wisdom of Age says:

   August 12, 2009 at 3:12 am

   Read the terms and caveats to both the PPO and HMO carefully. You will likely notice lower co-pays with the HMO but it is a difficult to see doctors of your choice and heaven forbid you have to go out of network. My wife had a cranial aneurysm that our HMO affiliated physicians said could not be repaired at their approved hospitals. Their doctor sent us out of network with the HMO’s approval in writing. When the bills came due, the HMO stated the approval was in error and initially refused to pay. By appealing to our SCC we reached a settlement. The next year we switched to a PPO. Her follow ups are fully covered and we do not need referrals. We can also choose the doctors and usually the facility. The benefits far outweigh the extra copay. Go with the PPO.
5. StephenWeinstein says:

   August 12, 2009 at 3:12 am

   First, I doubt that he will be able to obtain either type of insurance if he is already in chemotherapy. In his case, he should take whatever type of insurance he can obtain.

   Second, for a hypothetical person who has the option to select either type, I prefer a PPO. With a PPO, you have greater flexibility to go outside the network and still receive some benefits (typically 80%). With an HMO, you may receive 100% in the network, but you receive little or nothing elsewhere.