MemberSo I am on a plan that I can go back and forth between PPO and HMO plans. It’s a three tiered health insurance program. We are planning on having a baby soon and was wondering what the pros and cons were to each?
MemberI think out of pocket costs are sometimes lower with HMOs, but I’ve always preferred PPOs because you don’t always have to go to your GP first and get referred if you want to see a specialist.
MemberWe had an HMO, then switched to PPO. I admit, I don’t know all the subtle differences but we’ve been happy with the PPO. When considering our options, we chose what had the best coverage for maternity/prenatal care.
MemberHMOs generally require you to go to your primary care physician to get referrals to see a specialist. PPOs allow you to go to any doctor you want as long as they are in network and referrals are not required. I have a PPO and love it because I’m not limited to where I go, Fiance has an HMO and it’s a pain in the butt for him since he has to go to his primary and pay a copay, just for his doctor to confirm that he needs to see a specialist and get the referral.
MemberHMOs are definitely less OOP costs, however the extra costs for the PPO are worth it (to me) for the convenience – no PCP Gatekeeper.
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