Speak With A Licensed Agent:
1-833-4Med-Bob (TTY 711)

Call Now
Senior Healthcare Direct brought to you by Amerilife
Call Now

Speak With A Licensed Agent:
1-833-4Med-Bob (TTY 711)

HMO vs PPO Types of Medicare Advantage Plans

What's the Difference HMO vs PPO? Discover which type of Medicare Advantage plan may be best for you.

Share This Article

HMO and PPO are two popular types of Medicare Advantage (MA) plans. Let's compare these MA plans to determine which is right for you.

HMO vs PPO Popularity FAQs

HMO Coverage

HMOs provide in-network coverage . This Medicare Advantage plan generally covers doctors and other healthcare providers in your HMO network. The HMO plan also covers in-network hospitals.

Out-of-Network HMO Coverage

HMO plans may cover the following out-of-network services:

  • Emergency care

  • Urgent care

  • Dialysis

Common Questions About HMOs

PPO Coverage

Medicare Advantage PPO plans provide in-network and out-of-network coverage. In other words, PPOs cover healthcare from any doctor or hospital . Also, if you want prescription drug coverage, you need to join a PPO plan with drug coverage.

Common Questions About PPOs

HMO vs PPO Which is Better?

To determine which type of Medicare Advantage plan is best for you, let's compare cost and coverage.

HMO Costs

You generally pay lower premiums on HMOs versus PPOs, and your HMO deductible may be low or zero.

PPO Costs

PPO plans generally have higher premiums than HMOs. In addition, PPOs typically have a deductible. Thus, Preferred Provider Organization plans usually cost more than HMOs.

Coverage Difference HMO vs PPO

PPO plans may cover out-of-network care. However, HMO plans do not cover out-of-network non-emergency care.

HMO plans usually require you to select a primary care physician (PCP), and you typically need a PCP referral to see a specialist.

Finally, coverage differs in network size. PPOs generally have larger networks and give you greater selection of in-network doctors, specialists, and facilities. So, which is best for you?

Call 1-833-463-3262 to speak with a licensed agent at Senior Healthcare Direct and discover which MA plans have the doctors and hospitals you want. You can also get a quote.

Discover the differences between Medigap vs Medicare Advantage plans.

Share this page:

LEGAL DISCLAIMER: The above is meant to be strictly educational and not intended to provide medical advice or solicit the sales of an insurance product or service of any kind


B08142301