Do more people have HMO or PPO?
Asked by: Jamar Weimann | Last update: January 21, 2026Score: 4.1/5 (49 votes)
Do people prefer HMO or PPO?
Generally speaking, an HMO might make sense if lower costs are most important and if you don't mind using a PCP to manage your care. A PPO may be better if you already have a doctor or medical team that you want to keep but doesn't belong to your plan network.
Is PPO the most common?
Even if they don't have group coverage, it's likely their policy is a PPO plan. PPOs are the most common type of health plan available. KFF1 found that 46% of the roughly 153 million Americans with employer-sponsored health coverage had a PPO policy.
How common are HMO plans?
HMO enrollees made up 34.8 percent of the total U.S. civilian noninstitutionalized population and 41.9 percent of the population with health insurance (Table 1). The rate of HMO enrollment was significantly higher in the non-elderly population than in the elderly population (45.6 vs. 20.1 percent).
Why are PPOs more popular?
Some policymakers favor PPOs because they offer a model of managed care that is closer to traditional fee-for-service (FFS) than the health maintenance organization (HMO) options previously available to beneficiaries.
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Why do doctors not accept HMO?
HMO plans might involve more bureaucracy and can limit doctors' ability to practice medicine as they see fit due to stricter guidelines on treatment protocols. So just as with patients, providers who prefer a greater degree of flexibility tend to prefer PPO plans.
What is the downside to a PPO plan?
Cons of PPO Plans
Less Coordination: Without a primary care doctor managing your healthcare, there's less oversight, and it can be harder to keep track of your treatments and appointments.
What are 3 disadvantages of HMO?
- If you need specialized care, you will need a referral from your primary care physician to an in-network provider.
- Must see in-network providers for care-less flexibility than a PPO plan.
How many people have HMO vs PPO?
2023 Employer Health Benefits Survey
PPOs are the most common plan type. Forty-seven percent of covered workers are enrolled in PPOs, followed by HDHP/SOs (29%), HMOs (13%), POS plans (10%), and conventional plans (1%) [Figure 5.1]. All of these percentages are similar to the enrollment percentages in 2022.
Who has the largest PPO network?
Benefits of Multiplan/PHCS Network
The MultiPlan/PHCS network is the largest and most comprehensive independent PPO network in the United States , providing access to over 700,000 healthcare professionals, 4,500 hospitals, and 70,000 ancillary care facilities in all states.
When should I choose a PPO?
PPO: The plan with the most freedom
But this plan lets you see specialists and out-of-network doctors without a referral. Copays and coinsurance for in-network doctors are low. If you know you'll need more health care in the coming year and you can afford higher premiums, a PPO is a good choice.
What are the two most common health insurance plans?
Before choosing a health insurance policy for yourself, your family, or your employees, you must know what types are available. Some popular health insurance policy options are: Preferred provider organization (PPO) plans. Health maintenance organization (HMO) plans.
Why are HMOs so popular?
The main benefits are cost and quality of care. People who purchase HMO plans enjoy lower premiums than traditional forms of health insurance.
Is HMO or PPO better for pregnancy?
If you're happy with an insurer's network and don't mind seeing a primary care physician to get referrals to specialists, an HMO or EPO could be a cost-effective plan. However, if you prefer flexibility and don't want to be tethered to a PCP, you may prefer a POS or PPO plan.
What is a disadvantage of choosing Kaiser?
Limited plan types: Kaiser offers mostly HMO plans, so most members must work within Kaiser's network of medical providers. Low member experience ratings: Kaiser's member experience ratings, including customer service and getting needed care, are lower than most major providers.
What is the highest rated health insurance?
Investopedia's analysis ranks Kaiser Permanente as the best health insurance company for 2025 because of its blend of affordability and low customer complaints. UnitedHealthcare and Aetna also earned top marks. We evaluated nine insurers using dozens of criteria, such as customer satisfaction, plan types, and costs.
Why would a person choose a PPO over and HMO?
A PPO plan provides more flexibility in choosing your health care providers, but it may cost more than an HMO. Key areas to remember: Your maximum copay or coinsurance is less when you stay in network for services. You can see a specialist and access many types of services without a referral.
Why would you want a PPO?
Why would I choose a PPO? You have a doctor you like and you want to keep this doctor, and the doctor is in the PPO network. You want to see specialists and other providers without having to get referrals and pre-approval first. You want more of a choice of doctors and hospitals you can go to.
Why do people not like HMO plans?
On major disadvantage is that it is difficult to get any specialized care because the members must get a referral first. Any kind of care that is sought that is not a referral or an emergency is not covered.
Why are people against HMO?
HMOs tend to have higher maintenance costs than a standard buy-to-let since many people share them and often have a higher turnover of tenants. Wear and tear can be higher. Some tenant types, such as students, typically involve HMO landlords with more maintenance and repair issues than, say, a family tenant would.
What is a drawback to HMO insurance?
Limited provider options
For you to receive covered care, you must see professionals within this group. This lack of flexibility is a disadvantage of HMO insurance plans because, without easily accessible in-network providers, covered care will also be inaccessible.
Why is PPO the most popular?
Preferred provider organization plans offer more flexibility
You'll likely have several types of plans to choose from. One type of plan that often comes up is the Preferred Provider Organization or PPO plan. This plan is known for its flexibility, but it can also come with a higher monthly premium.
How do PPOs save consumers money?
mcap.dhcs.ca.gov/referred Provider Organizations (PPOs)
You pay less if you see these providers. These providers have contracts with the PPO to provide care at certain rates. If you go to a doctor or hospital that is not on the preferred provider list, you pay more.
What is better, HMO pos or PPO?
What's the difference between Medicare HMO-POS and PPO plans? Not much. They're both types of health plans you can choose for your Medicare coverage. Both types of plans allow you to go to doctors and hospitals outside of your network, but doing so may cost you more.