Frequently Asked Questions

  • A Health Maintenance Organization (HMO) is a type of health plan that limits coverage to a network of doctors who work for or contract with the HMO. An HMO won't cover out-of-network doctors except in the case of an emergency. Most HMO plans require patients to have a primary care physician, who then refers the patient to see specialists. HMOs often require members to live or work within its service area.

    A Preferred Provider Organization (PPO) is a health plan that contracts with providers like hospitals and doctors to create a network. Providers in the plan’s network are less costly. Patients can use providers outside of the network, but for an additional cost. PPOs do not require patients to have a primary care physician.