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Which is best for you?

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Types of Plans   >   Which is best for you?
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Which type of health plan is best for you and your family?

The type of plan you join can affect what services are covered, how much you pay, and which doctors and hospitals you can use. Here are some points to consider when deciding which type of health plan is best for you and your family:


Health Maintenance Organization (HMO)

If you join an HMO:

  • You must use the doctors and other providers in the HMO network.

  • Most HMOs ask you to choose one doctor to be your primary care provider (PCP). Your PCP takes care of most of your medical needs.

  • You have to get approval from your PCP before you can see a specialist.

There are advantages:

  • You usually pay only a small amount when you get care (for example, $10 for an office visit).

  • You have very little paperwork.

  • You may also receive better coverage for some services, such as preventive care.
Preferred Provider Organization (PPO)

If you join a PPO:

  • You can choose whether or not to use the PPO's network.

  • There are advantages if you do use the PPO's network.

If you see a doctor who is in the PPO's network:

  • You will pay less when you get care and you will have less paperwork.

  • You may also receive better coverage for some services, such as preventive care.

If you choose to see doctors and other providers who are not in the PPO's network:

  • You will pay more when you get care.

  • You will have to file claims to get payment.