HMO's vs. PPO's - MD Explains HOW to Pick a HEALTH INSURANCE Plan

What is a PPO? What is an HMO? What are the real differences between the two? Although an HMO may be cheaper than a PPO, you need to understand what you may potentially be giving up by choosing an HMO health insurance plan. In today's episode I go over the differences between HMO's and PPO's that even Insurance Brokers may not fully understand or explain to you. This is information you NEED to know when choosing a health insurance plan whether for yourself or even for your company.

Thank you for joining me on another episode of Baktari MD! Do you have a question regarding our healthcare system? Please leave your question in the comments below so I can make an episode about it. Also, I’d love to hear any suggestions you may have for future content.

00:00 Intro
01:31 HMO vs. PPO
10:19 The Pros and Cons to a PPO
12:43 The Downsides of an HMO
15:51 Hospital Care and Emergency Room Care with an HMO
24:22 Working with an Insurance Broker
26:49 Potential Downsides to a PPO to look out for

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Disclaimer: All information discussed or provided by Jonathan Baktari, M.D. (“Dr. Baktari”) and/or his affiliates/guests are for educational purposes only. The information discussed and provided is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical concern or condition. Never disregard professional medical advice or delay in seeking it because of any information discussed or provided by Dr. Baktari or his affiliates/guests! If you think you may have a medical emergency, call 911 immediately. All information concerning hospitals, physicians, insurers, and other healthcare-related companies is based on Dr. Baktari’s observations of the healthcare industry as a whole and do not reflect on any specific hospital, physician, insurer, or other healthcare-related company.

[Wanderhoof]

As a small business owner, this information is truly invaluable. Thank you for breaking it down in such an easy way to understand!!

[khafreahmose]

Im digging that library in the background! A well-read person is always respected!

[olskool]

Awesome information and my timing finding your video was right on time as I was struggling on choice selection and in the middle of open enrollment. This information helped me with my healthcare selection between two plans (HMO & PPO) that I had narrowed my choice down to. The cost between the two were only a $20 difference, PPO Preferred brand and non-brand drug copays were actually quite a bit cheaper, the PPO deductible only $1200 more than HMO but most everything else was identical very close in cost. Excellent detail and easy to understand information. Thank you!

[jennietorres]

I learned things I didn't know. VERY INFORMATIVE.

[introverteverfreddy]

I just enrolled Humana Medicare Advantage PPO few weeks ago, hoping it will be approved by Medicare.
Btw great review.

[FeCyndiW]

Thanks for this video; it is renewal time for my small business plan and it is so confusing. From my personal experience, control over your care matters. My late husband had fibrolamellar cancer. He ate well and was super fit (one of the best road bicycle racers in our state) when he got cancer. If it wasn't for the coverage we had, he would have died years earlier. We had to go out of our state for all his treatment. Bad things can happen to anyone. I don't want to saddle employees with more managed care and fewer choices. It will cost me more (I pay 90% for employees), but I am going with a PPO.

[Mickey-jnhz]

I am on Humana HMO, and possibly looking at another knee replacement…..what are your thoughts on transferring to a PPO which I had previously and transferred to an HMO so I could see a preferred acupuncturist and be covered. Now why is acupuncture covered be HMO and not Ridiculous!

[shainahuntsberry]

Are you saying that if you have HMO and you go to the ER with a severe & life-threatening condition, they may/can decide to not treat you (or even worse, let you potentially die)?

[philipjdry]

Why not just tax everyone and have that pay dentists doctors so everyone can go to a dentist with out out of pocket fees so everyone can be healthy And happy? I'm no rain man but....

[tracyguyton]

You clearly clerified what is a HMO v PPO and now I wish I would have gotten a PPO because hmo takes all the freedom of choices from you but I enjoyed your talk but next time get to the point and stop repeating your self I really don’t like that