The differences between an HMO (Health Maintenance Organization) and PPO (Preferred Provider Organization) include plan networks, costs, and flexibility. HMOs usually require you to visit doctors and hospitals within their plan’s network. You may have to get a referral to see a specialist from your primary care physician. If you go outside of the network for care, you may be responsible for 100% of your medical expenses.
HMO’s may have lower monthly premiums and doctor copays than a PPO, but a PPO may have a broader network of providers and more flexibility. A PPO may allow you to visit a specialist without a referral, and you may be able to go to a doctor outside of the network for a higher cost.