Does choosing a PPO plan always lower my total out-of-pocket costs compared to an HMO?

Direct answer

It depends on whether you prioritize lower monthly premiums with a restricted provider network (HMO) or the flexibility to see specialists without referrals at a higher cost (PPO).

Comparative analysis of health plan network structures and cost-sharing models provided by the National Association of Insurance Commissioners. For additional information about the structural differences between plan types, see the Healthcare.gov guide to plan types.


What this means for you

It depends on whether you prioritize lower monthly premiums with a restricted provider network (HMO) or the flexibility to see specialists without referrals at a higher cost (PPO).

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