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Old 10-23-09, 09:49 PM   #1
mepi
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PPO or HMO

Anybody got ideas on which is best. I am currently on HMO, but thinking of swithching to PPO. I don't ever realy use the insurance except for sports injuries which HMO seems to have taken care of with no problems and probably have used it less than 4 times in the last 10 years. I am thinking of moving to PPO because it gives me more flexibility - my job has moved so I live in a couple of places that are a few hours apart. I am thinking the PPO will let me go to wherever I want. My cost for either plan is 0, but is seems like the PPO is more expensive if I really need to use it as far as Co-Pays and deductibles. Any ideas which is best? I have a month to change my mind.
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Old 10-23-09, 11:00 PM   #2
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I have PPO because my preferred doctors are on that plan. With the HMO option I didn't really have a choice as to which doctor I used.
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Old 10-24-09, 07:31 AM   #3
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Do you have an HRA option?
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Old 10-24-09, 07:47 AM   #4
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Although you may be able to pick your own doctor, make sure what is covered. People at work are switching to Health Net and now they find out that some major surgeries are not covered as much as they thought they would be. Co Pays and deductibles for your current plan may be higher but in the long run it might be better than paying thousands should you need some major care.
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Old 10-24-09, 11:05 AM   #5
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I just figured they cover everything a HMO does so I better read up a little more on it to make sure. I don't think they have an HRA option - never heard of that before.
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Old 10-26-09, 02:47 PM   #6
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Check in and out of network coverage, as well as what the hospital fees are. When unconcious, paramedics are going to be rushing you to the closest emergency ward, not the closest in network one.
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Old 10-26-09, 10:00 PM   #7
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Check in and out of network coverage, as well as what the hospital fees are. When unconcious, paramedics are going to be rushing you to the closest emergency ward, not the closest in network one.
This viewpoint would generally tend to suggest PPO. The counterpoint would be that such an emergency should be rare enough that the typical savings of an HMO plan outweigh the risks. Also, I think a lot of plans now have exclusions for cases that are deemed emergencies.

However, I'd personally probably go PPO for the convenience. Commonly HMO's don't allow you to go straight to a specialist when you have a good idea what's wrong with you (like going to a dermatologist for a skin issue). You have to get a referral from your declared primary care doctor.
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Old 10-27-09, 07:23 AM   #8
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Hard to say without knowing the details of your plans. If you have an option for an HSA, that's where you need to be based on your history.
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