- HMO vs. PPO

[Guest guest]

,

I've had both - PPO during tx. HMO co-pays are less expensive, at least

with the policy(s) I have/had. You typically don't have to worry about all

the bs with invoices and the like. When I was first dx, I paid my co-pay

for and MRI, ultrasound, MRCP, etc and never saw a bill. Now that I'm

PPO, I pay the co-pay, in some cases, and then receive a bill later on.

Trying to figure it all out is a real pain.

So for ease of straight forward use, HMO is better. However, given the

specialist that Tony will need to see will require him to get referrals

(renewed annually) for everyone he sees. I was turned away the first time

I went to see my current GI because the paperwork hadn't made it all the

way through. I had to reschedule a month later - after taking a 1/2 day to

drive to his office. In addition, many services will initially be denied

if expensive and not seen as necessary.

PPO are nice in the fact that as long as he/she is in-network, you pay a

co-pay with no referrals needed. You have greater access to services.

The lifetime benefits are greater as Arne mentioned.

These are my experiences with the two types and its been 2 years since I

had HMO.

Darin