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What is the difference between an HMO and a PPO insurance plan?

HMO (Health Maintenance Organization) vs. PPO (Preferred Provider Organization) : An Overview

By far the biggest difference between the two types of plans is that HMOs have lower costs and PPOs have increased flexibility

What PPO plans offer

  • Broad range of covered services
  • Typically includes a coinsurance for many services (you pay a percentage of the cost of the service)
  • Often no coinsurance for preventive care
  • Usually there is a maximum amount your plan will pay annually
  • Most plans have deductibles that each member must pay before the plan will begin to pay
  • You can visit any dentist

What HMO plans offer

  • Many covered services, focused on preventive care
  • Typically a member pays a copayment amount per service
  • Most plans have no copayments for preventive care
  • No maximums or deductibles
  • You must visit a provider within the HMO network to receive coverage
  • Your general dentist will refer to you a specialist if necessary

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