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HMO vs. PPO Insurance

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Q. What is the difference between an HMO and PPO?

A. HMO is short for health maintenance organization. These plans are usually inexpensive: You pay a flat monthly fee and perhaps a small co-pay on each visit, but they generally carry little or no deductible. Meaning, you don't have to rack up $1,000 in medical bills before insurance coverage kicks in. An HMO will cover you from the start. However, you can only choose a doctor who participates in the plan or else you'll have to pay for the visit out of your own pocket. And if you ever want to see a specialist, you have to get permission from your primary care doctor. The only exception is for visits to an OB/GYN or an emergency situation. If you're young and in good health, an HMO might be a good - and inexpensive - choice for you. (Learn more about HMOs.)

PPO is short for preferred provider organization. These typically cost more than an HMO and may carry a deductible but, in return, you get more flexibility in your choice of doctors. You're still encouraged to see doctors within the network - those who have contracted with the insurance company. But you usually don't need to get permission from your main doctor to see a specialist. And if you choose to see a doctor outside of the network, you don't have to pay the full out-of-pocket amount like you would with an HMO. You're only responsible for the difference between the out-of-network invoice and your PPO's discounted rate. If you have children or a medical condition that requires frequent trips to the doctor, a PPO might be the plan for you. (Learn more about PPOs.)

Short-term health insurance offered through Alpha Phi

Are you no longer covered under your parent’s health plan and waiting for your employer’s group coverage to begin? Alpha Phi has a relationship with a company that offers temporary health insurance for recent college graduates.

Short term medical is a temporary health insurance plan (30-365 days) designed for people who are between permanent health plans. You choose the plan that best meets your needs and budget. Simply select from your choice of deductibles, rate of payment and length of coverage. Since this plan is not an HMO or PPO, the individual can choose her own doctors and hospitals.

Contact plan administrator to obtain a quote and for more information. Please reference Alpha Phi’s agent number and app source listed below.

Garity Associates
About Short Term Insurance (will download an attachment)
About Assurant Health (will download an attachment)

17 Accord Park Drive, Suite 107
Norwell, MA 02061

Agent: M413A
App Source: 0015