Ive been with the HMO for years now but now I am really looking at the lower co pays for the PPO
The HMO has no deductibles and has a cap per year of 1500 for co pays etc.
The PPO has a 600 family deductible and 300 individual and cap of 1500 per year but there are far more doctors I can deal with on it.
Decisions decisions
I dont pay a premium on either for me or my family again this year but I am really liking the PPO this year.
the big drawback to it is scripts are 35 for non generic whereas the HMO is 20
Full Version: HMO or PPO
I have been with a PPO plan for years.. but it depends on how many visits to the doctor you make and how often you use your insurance.
One way to offset the costs is to participate in a Flexible spending account if your employer offers that.
I rarely go to the doctor, so a PPO works great for me as the premiums (out of pocket) are only $14 every 2 weeks... it would be 10x that if I had an HMO.
That allows me to put more into retirement.
Everyone's situation is different though.
One way to offset the costs is to participate in a Flexible spending account if your employer offers that.
I rarely go to the doctor, so a PPO works great for me as the premiums (out of pocket) are only $14 every 2 weeks... it would be 10x that if I had an HMO.
That allows me to put more into retirement.
Everyone's situation is different though.
What?
I'm getting screw#d here in Cali! The available PPO's I'm offered have much higher annual out of pocket expenses, at least double plus higher copays than yours. Also, the PPO's have % co-pays for things like diagnostics/testing and hospital/surgery co-pays like 20% co-pay for negotiated services. My HMO's are also higher.
If I expected any major treatment/surgeries/unresolved illnesses that could be serious or where I would want to see a specialist without hassle and have access to IMHO more skilled doctors that **might** only accept PPO's, I'd go with the PPO. If I just expected routine care for simple things like annual exams - shots- flu/cold treatment, I'd go with the HMO or even PPO if I expected very few visits and scripts because the monthly payment might be cheaper.
I'm getting screw#d here in Cali! The available PPO's I'm offered have much higher annual out of pocket expenses, at least double plus higher copays than yours. Also, the PPO's have % co-pays for things like diagnostics/testing and hospital/surgery co-pays like 20% co-pay for negotiated services. My HMO's are also higher.
If I expected any major treatment/surgeries/unresolved illnesses that could be serious or where I would want to see a specialist without hassle and have access to IMHO more skilled doctors that **might** only accept PPO's, I'd go with the PPO. If I just expected routine care for simple things like annual exams - shots- flu/cold treatment, I'd go with the HMO or even PPO if I expected very few visits and scripts because the monthly payment might be cheaper.
QUOTE(cinderella @ Oct 14 2007, 09:12 PM) 
What?
I'm getting screw#d here in Cali! The available PPO's I'm offered have much higher annual out of pocket expenses, at least double plus higher copays than yours. Also, the PPO's have % co-pays for things like diagnostics/testing and hospital/surgery co-pays like 20% co-pay for negotiated services. My HMO's are also higher.
If I expected any major treatment/surgeries/unresolved illnesses that could be serious or where I would want to see a specialist without hassle and have access to IMHO more skilled doctors that **might** only accept PPO's, I'd go with the PPO. If I just expected routine care for simple things like annual exams - shots- flu/cold treatment, I'd go with the HMO or even PPO if I expected very few visits and scripts because the monthly payment might be cheaper.
I'm getting screw#d here in Cali! The available PPO's I'm offered have much higher annual out of pocket expenses, at least double plus higher copays than yours. Also, the PPO's have % co-pays for things like diagnostics/testing and hospital/surgery co-pays like 20% co-pay for negotiated services. My HMO's are also higher.
If I expected any major treatment/surgeries/unresolved illnesses that could be serious or where I would want to see a specialist without hassle and have access to IMHO more skilled doctors that **might** only accept PPO's, I'd go with the PPO. If I just expected routine care for simple things like annual exams - shots- flu/cold treatment, I'd go with the HMO or even PPO if I expected very few visits and scripts because the monthly payment might be cheaper.
thats what im thinking .. i can see the same doctors on the ppos and wouldnt need a referral for a specialist .. im still dealing with that cyst or whatever it is on my elbow .. have to have an mri done now and need the stupid hmos approval to do it ..
I have a choice between a PPO and an HMO and I think the former is better due to increased choice. I put copays, etc. on my flexible medical spending account.
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