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View Full Version : HMO, PPO, or EPO?


dandoosha
08-19-2002, 08:10 PM
What are the differences between the three and which is preferred?

Also, I'm in southern california does anyone have any idea what would be my best bet.

I used to be with Kaiser permenante and now it's time to renew...

Thanks so much!

Dana.

scbagrrrl
08-22-2002, 03:06 PM
Dana -
It varies somewhat from plan to plan - but generally HMO's are generally the most restrictive in regard to having to jump through hoops for care. PPO's are similar to an HMO, but your care is managed by a General Practioner - so he/she decides if you need tests or to see a specialist. EPO's are typically least restrictive. What they covers vary from state to state and plan to plan - so read up.

If you're healthy and no problems that require special care, then it's a lot less of an issue. If you have a lot of medical problems like I do, it can be a nightmare trying to navigate the system. I've actually turned down a job because they only offered HMO coverage. I'd gladly pay more each month not to have to fight to get meds and care that I need...

You might check with other friends/family members to see if they have insurance with that carrier and how they feel about it. (Even if they have the same carrier - what they cover/don't cover can vary by employer) But - you can get a general idea of how easy they are to work with and customer satisfaction.

ALSO, you might want to check with your state's insurance commissioner's website - or call them - ask if they have a list of complaints/ratings on the different plans. (ie - in my state of GA, Cigna has a horrible reputation for handling claims and has been fined significantly for it's customer service...)

Bottom line, read the fine print. It's a pain in the butt, but it's important to decide what's right for you.

Pinkroses
08-28-2002, 12:02 PM
At my place of work, we have a choice, HMO or PPO
I took the PPO. The way my insurance works is that I can pick any doctor I want to go to. There is a network of doctors, if I go in the network the insurance pays 90% and I pay 10% after the deductable. If I go out of the network, the insurance pays 70% and I pay 30% after the deductable. I found out that one of my doctors is in the network. Which is good. Another doctor I have is not in the network, but I am not giving him up. I dont like the idea of the HMO plan because you need referrals for doctors and you can only go to the doctors that they tell you. My sister has HMO, she hates it.

[This message has been edited by Pinkroses (edited 08-28-2002).]

 
 
 




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