Skip to main content

Back

Transcript: HMO, POS, PPO and HDHP: What’s the difference?

 

Health care answers in 60 seconds.

 

What's the difference between an HMO, a POS, and a PPO health plan?

 

Picture a garden, that's your network. It's made up of doctors and hospitals that have agreed to lower their rates while meeting quality standards. The fence around the garden separates in network from out of network.

Some plans require a primary care physician, or PCP, as a gatekeeper to direct you to in network care.

 

With an HMO, or health maintenance organization plan, you pick one PCP under your plan's network who provides routine care and refers you to in network specialists for additional care. HMOs will not cover out of network care.

 

With a POS, or point-of-service plan, you also have one PCP who manages your access to other doctors. However, you can visit doctors out of network but it will cost more.

 

With a PPO, or preferred provider organization plan, you don't need a referral to seek additional care. You have more freedom to choose which doctors to see, but out of network care will cost more.

 

Health care question answered.

 

Back