Medicare Advantage Plans: HMO vs. PPO
Medicare Advantage plans are often offered as HMO or PPO plans. Both provide coverage for your care, but they work in different ways.
Knowing how each plan works can help you choose the one that fits your needs best.
Difference Between HMO and PPO Medicare Plans
HMO and PPO are two types of Medicare Advantage plans that work in different ways.
With an HMO plan, you usually have lower out-of-pocket costs when you stay in the plan’s network. In many cases, you choose a primary care doctor who helps coordinate your care, but this can vary by plan.
With a PPO plan, you usually pay more for flexibility. You can see doctors in or out of the plan’s network, but out-of-network care often costs more.
In general, HMO plans focus on lower costs and in-network care. PPO plans focus more on flexibility and broader provider choice.
Care Coordination in HMO and PPO Plans
HMO plans, like those offered through KelseyCare Advantage, are built around a connected care system where your doctors work together. Your primary care doctor helps guide your care and works closely with specialists who share your medical information. For example, if you see a specialist, your primary care doctor can then view those results and help you understand the next steps. This can make your care feel more connected, since your doctors are working from the same information.
PPO plans take a different approach. They give you more freedom to choose where you go for care and which providers you see. For example, you may be able to see doctors or specialists outside of your plan’s network, which can be helpful if you want care in different places. Because you are not tied to one network, you may have more options for where you receive care, but your doctors may not always be part of the same system.
The best choice depends on what matters most to you in how you receive care.
The KelseyCare Advantage Difference
KelseyCare Advantage plans are built around the Kelsey-Seybold Clinic network in the Greater Houston area. Your care is connected across more than 44 locations and more than 65 specialties. Doctors and specialists work together and share medical records. This helps your care stay connected in one system. In most cases, you do not need referrals to see Kelsey-Seybold specialists, including orthopedics, cardiology, and neurology.
KelseyCare Advantage also offers an HMO-POS plan called Freedom. This option provides coordinated, in-network care, with flexibility to go outside the Kelsey network.
Explore KelseyCare Advantage Plans
KelseyCare Advantage plans are designed to offer coordinated care, local access, and support from a connected team at Kelsey-Seybold Clinic. Our licensed local agents are available to answer any questions you might have about our plans. Call us today at 713-442-5646 (TTY: 711).
