Difference between Preferred Provider Organization and Health Maintenance Organization
Basis |
Preferred Provider Organization (PPO) |
Health Maintenance Organization (HMO) |
---|---|---|
Structure |
Contracts with medical providers to form a network of participating providers. Patients can use both in-network and out-of-network providers, but out-of-network care is more expensive. |
Assigns a primary care doctor; patients require referrals from the primary care doctor to see specialists. Out-of-network providers are typically only allowed in emergencies. |
Benefits |
More flexible, offers a broader choice of providers, and includes out-of-network coverage at a higher cost. |
Affordable, emphasizes coordinated care, and encourages preventative care. |
Costs |
Higher premiums, copays, and deductibles compared to HMOs. Provides more flexibility and a wider range of providers. |
Lower premiums, copays, and deductibles. Limits choices in providers and necessitates referrals for specialist visits. |