HMO vs PPO? ? ?

[CaliforniabOY5 10+ year member]

So i have an HMO now but once a year my company allows up to change to new medical plans for no fees or anything. I am wondering if PPO is that much better. On paper it is MUCH MUCH MUCH more expensive; is the price hike worth it? I only have myself to worry about, no children but still... Does any one care to share personal experiances on medical insurance???

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[tommyk90 5,000+ posts]

Did you get any paperwork/pamphlets on the differences between the two?

Co-payments? Deductibles? Etc?

 

[CaliforniabOY5 10+ year member]

i have the 411... i'll scan!

 

[CaliforniabOY5 10+ year member]

 

[CaliforniabOY5 10+ year member]

or wait... i need MORE info... i gotta go find it..

 

[CaliforniabOY5 10+ year member]

from what i remember, hmo was 15 deductable per visit no annual deductible and NO limit on total medical cost. PPO was 10% of the doctor visit and 2-3million total with a 600 dollar yearly deductable //content.invisioncic.com/y282845/emoticons/frown.gif.a3531fa0534503350665a1e957861287.gif

 

[CaliforniabOY5 10+ year member]

i know what the differences are very clearly, im asking for personal experiances on both....

 

[crunktimes.com 5,000+ posts]

Depends on how sick of a person you are. Are you someone who just goes to the doctor once a year for a checkup or do you have a bunch of doctors?

If you just see a doc once a year or less than a few times a year I would go for what is cheapest.

If not the PPO might be better for you if you have to visit the doctor a lot.

Your prices are not that off from what I pay, maybe $9/mo more for the PPO which is what I get. You also need to find out what the difference in the two PPO packages is, usually it is one choice PPO or HMO so you need to find out what you miss if you go with the cheaper option of either.

 

[CaliforniabOY5 10+ year member]

i go to the doctor 3-4 times max a year on a horrible year. not out of the ordinary to go once a year for a checkup if im not sick. im only 19;

HMO sounds like what i should stick to.

By making this thread i was kinda hoping that ppl would have some stories if you are treated better based of ur plan or something undernear the numbers so to say..

 

[crunktimes.com 5,000+ posts]

The only real difference I know other than the prices you pay is that with a PPO you could have an issue where if you needed to see a specialist they may not have one as close as if you were PPO and could pick where you wanted to go.

 

[faulkton 5,000+ posts]

yeah i think it boils down to being able to choose who your doctor is.

ppo = go to any doctors you want

hmo = go to only their doctors

 

[MikeofTulsa Moderator]

me personally, i'd go w/ the ppo. Aetna is a great insurance company to deal with, and they have a very large doctor base.

 

[faulkton 5,000+ posts]

i thought you could use out of network providers with a PPO, but just paid a little more.

Maybe I'm wrong but that is the way i remember it.

There were preferred providers that cost less to use, but you could in fact use anyone you want.

who knows its been a few years since i had health insurance.