Planning for a family? Which insurance plan should you sign up for?
HMO vs. PPO: Planning for a family
Though the national deadline for individual insurance is January 15th, there still may be plenty of opportunities to enroll throughout the year.
Regardless of whether your company or your spouse’s company offers insurance, when it comes time to choose a plan during open enrollment or if you qualify for a special enrollment period, you may be wondering whether an HMO or a PPO plan is right for you.
HMO:
HMO stands for Health Maintenance Organization, though it is much more commonly referred to as HMO. A few things to note about HMO plans:
Limited Provider Network
In-Network only care
Primary Care Physician (PCP) required
Referrals required from primary care physician for any other care (i.e. MRI, CT, etc.)
Labwork and physical/occupational therapy covered at specific locations only
Lower premiums and out-of-pocket costs compared to PPO plans
PPO:
PPO stands for Preferred Provider Organization, though it is much more commonly referred to as PPO. A few things to note about PPO plans:
No PCP required
Coverage for in and out of network care
Nationwide access
No referral is needed and you can see any provider at any time
Higher premium and out of pocket costs compared to HMO plans
When you are planning to start a family, there are a lot of considerations to make. Typically, young parents wish to keep medical costs lower.
HMO plans can be used wisely and cover your family well with a little extra due dilligence and investigation of network and providers. HMO does not limit you in terms of not being able to see excellent doctors and surgeons, you just simply need to plan and do your research prior to receiving care.
PPO plans allow for more flexibility and you are not limited to a network, however it is higher out of pocket costs for the premiums and for coverage.
While it is ultimately up to you which plan you enroll in, it may be wise to speak to an insurance specialist to help you navigate your choices and figure out what works best for you and your family. Contact us today.
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Please review important information regarding the recent changes at Independence Blue Cross (IBC) and how they may affect you and your employees.