Tucson Health Insurance Brokers Can Help You Choose Between an HMO and a PPO

If you are new to the insurance market, it can be difficult to make the right choices.  For example, how do you know which is more appropriate for your needs – an HMO or a PPO?  How do you know if it’s a smart idea to choose an HSA with a high-deductible health plan?  To clear up some of the confusion you may have with the Arizona health insurance market; it helps to work with Tucson health insurance brokers who know a lot about the best health plans in Arizona. 

One of the least favorite parts of using an HMO has always been the “referral” process. HMO members are required to select a primary care physician (PCP) who acts as the entry point for any medical condition, with the exception of emergency care.  The PCP will then direct all aspects of a patient’s medical care, including referrals to network specialists who are under contract with the HMO.  It used to be that a paper referral would have to be picked up at the PCP’s office and physically brought to another doctor, but today’s electronic referrals have made it a whole lot easier.   

In general, the co-pays and prescription costs in an HMO are very affordable and there is no co-insurance or deductible to be met.   As a result, the HMO is an attractive plan for people who expect to have a lot of preventive care appointments and doctor’s visits.   The only downside here is that your PCP decides whether seeing a specialist is actually necessary.  Tucson health insurance brokers can give you a quote on an Arizona HMO plan.

PPO plans combine some of the more attractive features of an HMO, such as pre-set copays for doctor’s visits and prescriptions, with the flexibility of directing your own medical care.  While you will still need to stay within your insurance company’s network, known as in-network or preferred providers, you will be free to see a specialist any time without a referral.  Non-network providers are an option here, but they usually require higher co-pays or coinsurance.  Generally, the premiums for PPOs are higher than HMOs, and maternity benefits are often excluded from these plans.

Tucson health insurance brokers are able to help you find the best rates on an HMO, PPO or other type of individual health plan.  To learn more, contact Anderson Insurance Services today and ask for a free quote.