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HMO vs PPO Health Plans

HMOs and PPOs differ mainly in network flexibility and how you access specialists.

FeatureHMOPPO
Need a PCPYesNo
Specialist referralsRequiredNot required
Out-of-network careNot covered (except emergencies)Partially covered
PremiumsLowerHigher
PaperworkLessMore
Best for HMO
Generally healthy people who want low predictable costs.
Best for PPO
People with established specialists or who travel often.

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