Hmo Disadvantages

Health insurance has become a major subject in the United States today. In the past, not every citizen is covered. Today, almost everyone who has a full-time job is enrolled in a healthcare plan. The most common type of managed healthcare plans is Heath Maintenance Organization also known as HMOs and Preferred Providers Organization known as PPOs. Both organizations have advantages as well as disadvantages. Participants who are enrolled in the Health Maintenance Organization is required to receive care from a network provider who will decide all of your heath needs. Any special needs that require outside attention will need a referral. With that being said, the disadvantage of HMOs is the restrictions place on choosing providers. If a referral is not obtained, patients will most likely have to pay extra or all fees to receive the special care. One of the biggest advantages of this organization is the low cost of plans. In most cases, there is no deductible. You will only be responsible for co-pays. While HMOs tend to be more affordable, but you will usually get less coverage and more restrictions. There are four main HMO plans. The most …show more content…
Different from HMOs, you do not have an assigned PCP. You can choose doctors, hospitals, and other providers from the PPO network or out-of-network. Choosing an out-of-network provider will most likely cost more. You do not need a referral to see a specialist. However, some PPOs require that you get approval for certain services, such as X-rays. PPO Plans is also said to offer more benefits, but you will also have to pay more money. PPOs are more flexible and provide greater coverage, but has a higher price tag and most likely a deductible. Most PPO plans operate the same to each, with the difference between them being how restrict they are in primary care. The two most common plan is the gatekeeper PPO and non-gatekeeper