What is the difference between a HSA and a HMO?
Asked by: Mrs. Mona Ziemann MD | Last update: October 5, 2025Score: 4.3/5 (49 votes)
Is it better to have an HSA or HMO?
When you select an HMO you'll likely get a better price than an HSA but you will also be much more restricted in what doctor you can see because expenses for out-of-network physicians or hospitals won't typically be covered. An HMO will often have a very low deductible or none at all.
What is the downside to HSA insurance?
HSA Cons. The big drawback of an HSA is that you have to sign up with a high deductible health plan to be eligible for one. It is difficult to forecast medical expenses accurately.
What are three 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.
Do doctors prefer HMO or PPO?
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.
HMO vs. HDHP Health Insurance: Which One is Better?
Who is an HMO good for?
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.
What is the downside to a PPO plan?
In general, PPO plans tend to be more expensive than an HMO plan. Your monthly premium will be higher and you will have to meet your deductible before your health insurer starts paying. You will also have to pay more out-of-pocket if you visit a provider who is not part of your PPO network.
Why do people not like HMO plans?
Cons of HMO Plans
Referrals Needed for Specialists: To see a specialist, you must first get a referral from your primary care doctor, which can delay care. Less Flexibility: If you often need care outside your network or prefer more choice in doctors, an HMO may feel restrictive compared to a PPO plan.
What is the primary problem with an HMO?
Without a referral, you don't have permission for those services, and the HMO won't pay for them. The benefit of this system is fewer unnecessary services. The drawback is that you have to see multiple providers (a primary care provider before a specialist) and pay copays or other cost-sharing for each visit.
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.
Who should not do an HSA?
Not everyone is eligible: If you are claimed as a dependent on someone else's tax return, you're ineligible for an HSA. For people enrolled in HDHPs only: Only those with high-deductible health plans qualify for an HSA. Meeting a high insurance deductible might be a hardship.
Is it better to have an HSA or a PPO?
In California, where the tech industry thrives and many employees are younger, healthier, and more likely to value long-term savings, an HSA may be the better option. These employees are more likely to benefit from the tax advantages and the ability to invest unused funds for the future.
What happens to your HSA when you turn 65?
Once you turn 65, you can use the money in your HSA for anything you want. If you don't use it for qualified medical expenses, it counts as income when you file your taxes.
What are the disadvantages of HSA?
The main downside of an HSA is that you must have a high-deductible health insurance plan to get one. A health insurance deductible is the amount of money you must pay out of pocket each year before your insurance plan benefits begin.
What happens to my HSA if I switch to HMO?
Yes—the short answer is that just like with an HSA and PPO, you can use an HSA with an HMO. But again, just like with a PPO, not with just any HMO. Since an HSA isn't actually a type of health insurance, HSAs provide the flexibility to be integrated with any HSA-eligible high-deductible health plan (HDHP).
Which healthcare insurance is best?
- Best Overall and Best for Self-Employed: Kaiser Permanente.
- Best Widely Available Plans: UnitedHealthcare.
- Best for Low Complaints and Best for Chronic Conditions: Aetna.
- Most Affordable: Molina Healthcare.
What is a drawback of having a HMO?
Cons Explained
Must use medical professionals in the plan's network: You're restricted on how you can use the plan. You must designate a doctor within the network who will be responsible for your healthcare needs, including primary care and referrals.
Which is better, PPO or HMO?
PPOs Usually Win on Choice and Flexibility
If flexibility and choice are important to you, a PPO plan could be the better choice. Unlike most HMO health plans, you won't likely need to select a primary care physician, and you won't usually need a referral from that physician to see a specialist.
Why do HMOs have such a bad reputation?
Sadly, many HMOs are run by either incompetent or corrupt bureaucracies, thereby compromising necessary patient care in lieu of their bottom-line. That said, some HMOs are better than others, and both patients and doctors must do their due diligence to determine whether or not to participate.
What is a drawback to HMO insurance?
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 would someone choose HMO?
HMO plans are generally less expensive than PPO plans, with lower monthly payments, making them ideal if your favorite doctors are already in the network, or if you receive most of your care close to home.
Why do many patients prefer a PPO?
PPO plans give you more choices when picking health care providers than other types of insurance. In a PPO plan, you have a network of “preferred” providers. These include doctors and specialists who can offer care at the lowest out-of-pocket cost, compared to out-of-network providers.
How do I know if I belong to a PPO or HMO?
However, if you've already got a health plan and don't know which plan type you have, you can check your insurance card or contact your insurance provider directly. If you have an online account through your provider that allows you to access plan details, you can also start there.