The primary difference is that HMOs limit your non-emergency health care coverage to a limited network of physicians and hospitals. PPO plans insure covered services delivered by any licensed physician or hospital, though a PPO plan will offer improved benefits if you use physicians and hospitals participating in the PPO's preferred network. PPO networks are normally much larger than HMO networks, though HMOs provide higher benefit levels.

PPO stands for Preferred Provider Organization which consists of a group of health care professionals who provide care to a specified group of patients. Patients in a PPO typically have greater choice in selecting care providers than they would have in an HMO. Unlike most HMOs, the patient often has the right to obtain services outside of the list of providers, but the patient may pay a higher fee.

participate in the Health Net of the Northeast network. Out of network services or expenses will not be covered. The HMO plan requires co-pays at the time of service. The United Healthcare PPO plan covers both in network and out of network physicians and facilities. The PPO plan uses deductibles. The deductible is lower and the insurance reimbursement is higher when you use in network providers.

In an HMO, the insured's choice of doctors and hospitals is limited to those that have agreements with the HMO to provide care. Exceptions are made in emergencies and when medically necessary. In contrast, an insured in a PPO can use doctors who are not part of the plan and still receive some coverage. In such cases, the insured will pay a larger portion of the bill him/herself and will have to fill out some claim forms.

No, we offer indemnity plans where you can make your own choice of any dentist in the state you live.

HMO: Members must select a PCP and members can see most in-plan specialists within our network without first obtaining a referral from their primary care physician. POS: Provides members with the greatest freedom of choice in-network and out-of-network. Members can use our participating providers to receive the highest level of benefits, or they may choose to go out-of-network to visit a doctor of their choice and receive a lower level of benefits.

Most HMOs require you to select a specific doctor as your primary care physician, or PCP. This doctor is supposed to be your first "port-of-call" for most any medical condition, although exceptions are typically made for emergencies. As such, he or she will end up providing most of your medical care.

HMO is a Health Maintenance Organization, which requires you to select a primary care doctor who helps you manage your health care needs. A PPO is a Preferred Provider Organization, which allows you to select any doctor within the network at the time of service without having to first identify a specific primary care provider. It allows for greater freedom of choice.

Yes. To view the Self-Funded PPO and HMO wellness programs, click the links below. In addition, the Wellness Benefit in the Self-Funded PPO plan has increased the benefit from $600 to $2500. The following preventive care procedures have also been added to the Self-Funded PPO plan: tobacco use cessation, weight control programs, skin cancer screening, routine hearing screening and stress management.

Traditional major medical expense plans are classified as indemnity contracts. These plans indemnify, or reimburse, the insured for medical expenses incurred and may require the completion and filing of claim forms. These plans usually contain deductible and coinsurance cost sharing provisions and may restrict coverage for certain types of medical care. Indemnity plans, however, allow the insured the freedom to choose any primary care physician or specialist.

In 2006, regional Medicare Advantage PPO plans became available to consumers eligible for Medicare. Check out the key features and advantages of these plans:

Health Maintenance Organizations (HMO's) require a patient to select a primary care physician to coordinate his or her care. Most HMO's provide care through a network of hospitals, physicians and other medical professionals that, as a patient, you must use to be covered for that service. Preferred Provider Organizations (PPO's) provide care through a network of hospitals, physicians and other medical professionals.

HMO/PPO insurance company sets a cap on fees that can be charged for procedures. By joining a HMO/PPO group, the dentist agrees to abide by these restrictions, which enables the company and the patient to know the predetermined costs. Because fees are controlled, it is possible that a participating dentist may need to control your treatment options, the materials used and the time that can be spent with you during treatment, none of which can be construed as beneficial to you, the patient.

By assembling a network of providers who agree to provide services at a discount (PPO) or by requiring you get all of your services from a specific provider, with an emphasis on preventative care (HMO), the hope is to provide you the best possible care at the lowest possible costs. A downside is such benefits and discounts require a great deal of control over your health care options by the PPO or HMO, and not all the limitations are popular or convenient.

HMO stands for Health Maintenance Organization. An HMO is a group that contracts with medical facilities, physicians, employers and occasionally individual patients to provide medical care to a group of individuals. An HMO patient must select a Primary Care Physician (PCP) contracted with their HMO. The patient’s PCP is responsible for referring the patient to any and all additional providers (specialty care physicians, hospital, etc).

PPO members are not required to stay within the PPO network, but there is usually a strong financial incentive to do so.

Only during your company's Open Enrollment period. If your employer-sponsored plan is the Dual Choice Dental Monthly Switch Option, you can switch between the PPO and DeltaCare on a monthly basis.

Both a Preferred Provider Organization (PPO) plan and a Health Maintenance Organization (HMO) plan use provider networks. Medical providers in both types of plan networks have contracted to provide their services and facilities to plan participants at reduced costs. Participants of a PPO plan have complete freedom in choosing physicians and medical facilities whenever in need of care.