Group Health

What is an HMO and a PPO?

"HMO" stands for Health Maintenance Organization. This is a network of health care providers, such as doctors, hospitals, pharmacies and other medical professionals. If you are a member of an HMO, you will select a primary care physician from a network directory. This person will coordinate all of your health care needs, and refer you to a specialist within the HMO network.

"PPO" stands for Preferred Provider Organization.  This is a managed care arrangement consisting of a group of hospitals, physicians, and other providers who have contracts with an insurer to provide health care services to enrollees at a predetermined rate.

PPOs also allow members to see physicians and hospitals out of the insurance company's network, however, these visits will require higher out-of-pocket costs for the member.