In order to help you decide which plan is right for you, you’ll want to know what each plan means. HMO, POS, and PPO are all acronyms for different types of managed care plans within your area. It can be hard knowing what you’re buying from the name alone – assuming you are someone who knows what the acronyms stand for.

All plans use a network of doctors and hospitals. The difference is how large the networks are and how you use them. Let’s look at the different options.

HMO: Health Maintenance Organization

• Requires you to select a primary care physician (PCP)
• Covers only care provided by doctors and hospitals inside the HMO’s network
• Tends to have lower monthly premiums
• No deductibles
• Good for preventive care services (checkups, immunizations)

With an HMO plan, you are able to see a primary care physician first. The primary physician will try and help initially, but will refer you to a specialist if you need further care. By having an HMO plan, you are able to develop a relationship with a primary care physician. You will then get referrals to doctors that have been recommended and won’t have to search for ones on your own.

POS: Point of Service

• Less restrictive
• Can receive out-of-network care
• Minimal co-payment
• No deductible when using network providers
• Out-of-pocket costs limited

A POS plan would allow you to receive care outside of your network in some cases. Let’s say you were going to be out of town for several months. Before you leave the state, you would work with your primary care physician to find a doctor to see while you are out of town.

PPO: Preferred Provider Organizations

• Have a network of providers they prefer to use
• Less restrictive
• Higher monthly premium and higher cost-sharing
• Will cover care both inside and outside the plan’s provider network
• Do not need a primary care physician, can see a specialist directly

If you have a PPO plan, you do not need a primary care physician. An example of how you can use a PPO plan: If all of a sudden you started getting pains in your foot, you could go directly to see a podiatrist without receiving a referral beforehand. A PPO allows you to see doctors inside or outside your network, but if you stay inside you’ll pay less.

PER Can Help You Find the Right Insurance Plan

Professional Employer Resources, Inc. (PER) can work with you to determine what type of healthcare plan or plans work best for your business and your employees. No matter what administrative, human resources, insurance, or payroll needs you have, PER can assist with the administrative burden so you can relax and do what you love. Contact us today at 888-599-4990 to learn more about our services and to receive a free cost analysis.