What’s the Difference Between An HMO and a PPO?

When you’re choosing health insurance, there are many decisions to make, including what type of health insurance to sign up for. There are many kinds of health insurance. Some of the most popular types of health insurance include HMOs and PPOs. Unfortunately, many people don’t know the difference between these two types of plans.

The type of health insurance you choose can affect you for a long time. It can have consequences for your health and your experience of healthcare. It’s important to make a thoughtful decision based on having all the information. 

Your insurance agent at Freeland Insurance servicing Oklahoma City, OK can help. We can answer your question about different types of health insurance plans so you can make an informed decision. 

What Is An HMO?

Health maintenance organizations, called HMOs, consist of a network of doctors, providers, and healthcare facilities that provide their services for a pre-determined amount. This pre-determined amount is what allows HMOs to set their rates. People with an HMO plan must typically stay in-network to get insurance coverage for their medical care. 

What Is A PPO?

A PPO is a preferred provider organization. These health plans allow patients to choose providers inside or outside their network. Patients who choose providers in their own network usually pay less. PPOs give their patients the freedom to choose providers as needed.  

Which One Is Best?

The type of plan that’s best for you depends on your healthcare needs, budget, and more. HMOs often involve fewer out-of-pocket costs for patients, but also give insureds fewer choices. HMOs pay providers directly and can be more streamlined for patients, as long as they stay in-network. PPOs may require patients to pay doctors and make a claim if they go out of network. 

Need Health Insurance? Call Today

Choosing a health insurance policy can be difficult. This is why many people turn to Freeland Insurance servicing Oklahoma City, OK. We’re here to help. Call today to speak with a helpful member of our team. 

Can You Switch Health Insurance Companies?

Yes, you can technically switch health insurance companies, but it’s not always as simple as deciding you want something different and making the change the next day. The ability to switch depends largely on timing and what’s happening in your life at that moment, so you should get with your insurance agent at Freeland Insurance, serving Oklahoma City, OK for details.

When Switching Is Allowed

Most people can only switch health insurance companies during specific enrollment windows. The most common is open enrollment, which happens once a year. Outside of that period, a switch is usually allowed only if you experience a qualifying life event. That could include getting married, moving to a new area, having a child, or losing existing coverage. Without one of these events, changes are often limited until the next enrollment window opens.

How Employer Coverage Fits In

If your health insurance comes through an employer, the rules are usually tied to the company’s benefits calendar. Many employers allow changes once a year during their own enrollment period. Certain life events may also allow adjustments mid-year, but those changes generally need to be made within a short timeframe.

Things People Often Overlook

Switching health insurance companies isn’t just about picking a new name. Provider networks can change, which affects whether current doctors and specialists are still in-network. Prescription coverage can also differ.

Timing and Coverage Gaps

One of the biggest concerns when switching is making sure coverage lines up correctly. Overlapping dates or short gaps can cause confusion later, especially if care is needed during the transition.

Switching health insurance companies is possible, but it works best when it’s planned carefully. Contact Freeland Insurance, serving Oklahoma City, OK, for assistance with your individual circumstances, to avoid any potential complications with your choice to change your health insurance.