PPO and HMO are the two network types you'll run into most often. Both can be good plans — the right choice depends on how much flexibility you want and how you prefer to access care.
HMO: lower cost, more structure
HMO plans usually have lower premiums but require you to stay in-network and get referrals from a primary care doctor to see specialists. Out-of-network care generally isn't covered except in emergencies. If you're comfortable with that structure, an HMO can save money.
PPO: more freedom, more choice
PPO plans let you see specialists without referrals and offer some out-of-network coverage. They typically cost a bit more, but for many people the flexibility — especially the ability to keep specific doctors and get care while traveling — is well worth it.
Side-by-side
- Referrals: HMO requires them, PPO doesn't
- Out-of-network: HMO no (except emergencies), PPO yes (higher cost)
- Premium: HMO usually lower, PPO usually higher
- Flexibility: PPO wins, HMO is more restrictive
Quick way to choose
- Want the lowest premium and don't mind referrals? HMO.
- Want to keep specific doctors or travel often? PPO.
- Not sure? Compare both for your situation before deciding.
Get help deciding
A licensed advisor can check whether your doctors are in each plan's network and show you the real cost difference, so you can choose the network that fits your life — at no cost.
