From the article: HMOs vs. PPOs – What Are the Differences Between HMOs and PPOs?
The most common types of managed care plans are preferred provider organizations (PPOs) and health maintenance organizations (HMOs). Many people do not fully appreciate the consequences of not using a doctor or hospital in their health plan. Have you had any problems getting the care you need from your PPO or HMO?
Mrs.
- I had BCBS Medicare HMO and was not allowed to use the regional hospital where most of my doctors had priveleges.
- —Guest Jan
interesting
- this was an interesting and very helpful blog posting with a lot of information in the area of HMOs
- —Guest sam
Both plans are NOT for the patient
- My mom retired with full insurance (HMO) and when she needed a Dr., she always had to go out of her way to get to their choice. In an emergency in which she was misdiagnosed, they assured her the Dr. was covered, when in fact he wasn't and she ended up paying for all costs out of pocket- not easy to do on SS/pension. Come to find out, some 10+ years later, they had given her the wrong insurance and all along, she could have had care 2 miles from her home, everything covered. Will she ever be reimbursed? No! Same with me- I had a PPO and always fought with the insurance co. on getting pre-approvals (Not easy to do in an emergency) and high deductibles. Why can't insurance be more patient-friendly with less hassle and paperwork, after-all, when you are sick, you don't need the aggravation. And then when you do have to talk to them to explain (not all who work there know what's going on), they wonder why you have an attitude! KISS
- —Guest Rob
In net
- Some of the doctors I want most are out of network and cost much more. Some are independent--they don't want to be told what they can and cannot do for their patients, and some insurances won't pay them. But, the insurance companies that offer PFS services have withdrawn their services from my area (we only have network insurances available.
- —Ra416
Individual PPO
- I too had issues w/ my BCBS, but I am in the individual market, not employer sponsered. I did a lot of research and found a PPO that works great for me and my son, and being self employed it has membership perks for that as well. My agent, Doug, is right on top of things and always picks up his phone! If your in N.FL call him! http://douglewin.abbaplans.com Two thumbs up!
- —Guest Catherine
Found Great Plan
- I had some problems with my previous ppo plan so I switched companies and the service and help i received with my new plan made a difference. Having a good company is a plus, so check them out.I found mine in Nevada from www.HealthInsuranceOfNevada.com Thanks!
- —kolan
