hmo health insurance

Pro and Cons of HMO and PPO Health Care Plans

How to Find Affordable HMO Health Insurance and Pro and Cons of HMO and PPO Health Care Plans

Start by contacting your State Insurance Commissioner’s office. The Insurance Commissioner’s office should be able to provide information about health insurance programs that are available in your state, including affordable HMO health insurance.

Do a Web search using the term affordable hmo. If you want to compare affordable HMO health insurance options available by state, check out AARP’s HMO Report Card.

Faced with ever-increasing medical costs, selecting the best health plan for you and your family requires informed decision-making on your part. There are two basic forms of employer sponsored health plans: HMO & PPO. Compounding the problem, individuals without a health insurance plan, even after diagnosis, receive less treatment. Studies also show that individuals without a medical plan are hospitalized 30-50% more often for avoidable conditions.

Managed Health Care Benefits

Managed health plans reduce medical costs to enrollees, allowing them to receive medical care that they might not otherwise be able to afford without a medical plan. Health insurance companies develop contracts with health care providers, promising to provide specific doctors and hospitals with more business through their health insurance. HMOs and PPOs are both managed medical plans that reduce the cost of medical treatment by combining contributions of enrollees and gaining the benefits of scale.

There are other medical plan mechanisms put into place to reduce medical costs by encouraging such incentives as preventative care, enforcing limitations to coverage and increased beneficiary cost sharing. There are significant price, service, and flexibility differences between these two types of medical plans. Whichever medical plan you select, you will be able to receive more medical care for far less money than if you had no insurance at all.

HMOs, or Health Maintenance Organizations, are health plans characterized as cooperatives of doctors, hospitals, and other medical providers. HMOs such as Kaiser Permanente and Aetna are your least expensive and most restrictive health plan. Under HMO policies, health insurance providers have agreed to provide their services at fixed prices and copayments are generally very low. HMOs focus primarily upon preventative services such as immunizations and physicals. HMO doctors are paid on a per office visit basis.

PPOs, or Preferred Provider Organizations, are health care plans that have contracts with insurance companies to reduce medical expenses to enrollees. Enrolling in a PPO provides you with more control over your health care plan as well as greater autonomy. Unlike HMOs, emergency room visits are generally covered under PPO medical plans. One aspect of a managed health care plan is that treatments are reviewed by the insurer. Eat right, stay fit, and enroll in a health care plan!

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