PPO vs. HMO

Difference between ppo and hmo

Multinational companies usually are torn between profit and the actual welfare of its employees. And the most commonly debated incentives or labor right as mandated by law is the right for a health benefit.  A chunk of the funds allocated for the total operation of the business is solely given to health benefits. Luckily, there are two famous manage health programs that exist in the United States today; the HMO and PPO. The difference between the two, the PPO or the Preferred Provider Organization unlike the HMO or Health Maintenance Organization – the employees have the freedom to choose or have a consultation to a doctor of their choice notwithstanding the burden of paying the whole bill by the employee alone.

It is the usual standard in the United States most especially among corporations, that employers have the responsibility of providing their employees with a reasonable, sustainable and well-rounded health care service. This may come in the form of a just compensation commensurate to the disability or illness; or an extensive health insurance. These managed health programs will come to hire a medical team that will ensure the health needs of the employees.  Competent health care professionals like doctors, nurses, dentists and the likes plus a state of the art facility that may include hospitals and clinics with its corresponding labs, pharmacy and x-ray facilities are the usual package that comes with working with multinational companies who are taking advantage of a solid health care program. In some cases, employers may mandate the employees to an affiliated health facility or they may be directed to a clinic or hospital of choice and let the health insurance of the employee as given by the employer to cover the expenses and a portion or all of the medical bills will be reimbursed later.

What makes HMO or Health Maintenance Organization distinct from PPO is that the employer will be required to provide the employees with a pool of competent medical team, a state of the art hospital and clinics fully equipped with the needed equipment.  The employer will assign a physician who shall provide all the personal and basic medical needs.  If the need for a specialist arises, the assigned physician shall refer the case to a specialist within the pool of medical team. This condition is not absolute. In the event that the employee wishes to seek medical advice out of the assigned medical team, the employee will be held responsible in the payment of the bill. On the other hand; PPO or Preferred Provider Organization is made up of a network of General Physicians and Specialists. In this program, the employee will have an option to choose a health care provider from the preferred network. If the employee wishes to seek the service coming from the preferred network; the employee is only liable for the predetermined yearly deductible from the bill. If they wish to employ a physician outside of the network; then the employee shall take the cudgels of paying the amount at a much higher price. And then make a requisition under PPO for a possible reimbursement.

In both medical plans, the employer is obliged to provide the employees with health covers. Usually, employees prefer PPO because of its wider range and higher satisfaction rating because they utilize health services from their own choice. In general, employers do not only cover the employees alone but with their immediate family as well.