11481 St. Augustine Rd. Suite 201, Jacksonville, FL 32258  (904) 886 4293  Fax: (904) 886 0082

 

Health Maintenance Organization (HMO) is a form of health insurance combining a range of coverages in a group basis. Preferred Provider Organization (PPO) is a health care organization composed of physicians, hospitals, or other providers which provides health care services at a reduced fee.
 
Differences: HMO
Health Maintenance Organization		 PPO
Preferred Provider Organization
How much I pay? Co-payments of $5 to $15 for every visit.

There are no deductibles to meet.

You pay the entire bill until you meet your deductible (typically from $200 to $1500). After that, you pay a percentage of every medical bill; the percentage is lower if you use a doctor in the PPO's network. There is a cap on total out-of-pocket expenses if your medical costs are considered “reasonable and customary”.
How I choose a doctor? You must select a doctor from the HMO's network to have your care paid for. You can choose your doctor.
How to see a specialist? You must get a referral from your primary care doctor to see a specialist. You can chose your specialist.
The kind of healthcare services I get? Preventive care is provided and paid for on a regular basis; you may also have access to health improvement programs. Typically preventive care services or health improvement programs are not covered.
The plan's responsibility for quality of care? The plan bears responsibility for the quality of care you get. The plan takes no responsibility for
the quality of care you get.