HMOs vs. PPOs

Re: HMOs vs. PPOs

^^ Well, the Prefered Provider Organization is not worth much if everybody is in the network. Believe me, the credentialling process at the insurance companies and the hospitals should not replace your own research. Many state surveys are available on line for hospitals, and some of the Joint Commission surveys may be too. there are various levels of commendation, from barely passing to really excellent. If your network does not include the really esxcellent hospitals, then they are skimping, and contracting with second tier providers.

Re: HMOs vs. PPOs

OG: Can you list some such research/reports (website would be fine too) detailing on doctors/hospitals?

Re: HMOs vs. PPOs

The benefit package I got basically has a table that shows the coverage and co-pays and deductibles but it doesn't like a website where I can go and check these PPOs and EPOs and HMOs to find out if I can even find a hospital or specialist near by or not.

Re: HMOs vs. PPOs

Ahmadjee, goto the website of that insurance company, and navigate thru to "Find providers" and you should be able to find from there what doctors/hospitals are covered.

Re: HMOs vs. PPOs

If you don't know a lot of doctors in your area, anyway, and are not likely to excessively seek out specialists etc, then stick with HMO for one year and get a decent PCP which is convenient and near your place. After a year, once you can actually make an informed decision based on non-HMO doctors and who you want to go to, then in the Open Enrollment period, you can always switch to PPO.

In our case, we have PPO, but all three of my kids still go to the same paediatrician who was their PCP when we were with HMO. Having PPO is only a peace of mind factor. The deduction is higher and the co-pay is higher as well. Unless you know several doctors in your area, and actually contemplate using one who is not in your HMO network, then you should pay extra for the PPO.

Its not like if you make a choice now, you are stuck with it forever. Many companies even allow a switch mid-term as well, if you make a good case.

Re: HMOs vs. PPOs

Captain, the Gold Standard for Hospital Quality is the Joint Commission for the Accreditation of Healthcare Organizations (JCAHO). You can use the Quality Check feature that presents disclosure by Zip Code.

http://www.jcaho.org/general+public/index.htm

Re: HMOs vs. PPOs

yes ahmadjee pls say no to HOMO...it is haraam and unnatural..

Re: HMOs vs. PPOs

^ lol