To start, HMO stands for Health Maintenance Organization, and the coverage restricts patients to a particular group of physicians called a network. PPO is short for Preferred Provider Organization and allows patients to choose any physician they wish, either inside or outside of their network.

What does PPO insurance cover?

Unlike an HMO, a PPO offers you the freedom to receive care from any provider—in or out of your network. This means you can see any doctor or specialist, or use any hospital. In addition, PPO plans do not require you to choose a primary care physician (PCP) and do not require referrals.

What is the difference between EPO and PPO?

A PPO (or “preferred provider organization”) is a health plan with a “preferred” network of providers in your area. An EPO (or “exclusive provider organization”) is a bit like a hybrid of an HMO and a PPO. EPOs generally offer a little more flexibility than an HMO and are generally a bit less pricey than a PPO.

Why is PPO more expensive?

PPO plans generally are more expensive than HMO plans. However, due to the pooling of people in a PPO network, fees associated with health care will be lower for participants. In other words, you will pay far less for services if you are in a PPO plan vs. not having insurance at all.

Why is EPO more expensive than PPO?

EPOs are usually cheaper than PPOs due to the restrictions on which healthcare providers you can visit. See also Coinsurance vs Copay. Varies. Premiums higher than EPO’s, may or may not be higher than HMO’s.

What does PPO stand for in health insurance?

Financial health What is a PPO? PPO stands for preferred provider organization. Just like an HMO, or health maintenance organization, a PPO plan offers a network of healthcare providers you can use for your medical care. These providers have agreed to provide care to the plan members at a certain rate.

What are the benefits of a PPO plan?

A PPO health insurance plan allows for more flexibility and more choices when it comes to your healthcare. Learn more about the features of PPO plans. Skip to main content Other Humana Sites Humana.com For Providers For Employers For Agents & Brokers For Investors For Caregivers MyHumana Go365® Wellness Program Humana Pharmacy® Help Español

What’s the difference between a PPO and an EPO?

Preferred provider organizations(PPOs) cover care provided both inside and outside the plan’s provider network. Members typically pay a higher percentage of the cost for out-of-network care. Exclusive provider organizations (EPOs) are a lot like HMOs: They generally don’t cover care outside the plan’s provider network.

How does a preferred provider organization ( PPO ) work?

HMOs often require members to get a referral from their primary care physician in order to see a specialist. Preferred provider organizations (PPOs) cover care provided both inside and outside the plan’s provider network. Members typically pay a higher percentage of the cost for out-of-network care.