The health insurance plan you choose makes a determining factor in your doctor choice. There are many possibilities, but there are two primary types. An HMO or health maintenance organization and a PPO also known as a preferred primary provider organization are the leading health insurance plans that are offered. Both of these can provide you with the coverage you need, but each has a difference in how one can choose a physician. You need to understand these differences and how they can affect you.

HMO plans will request that you decide on a primary care physician for your general medical needs. These can include basic physical exams and routine doctor visits. If you get sick from a cold or some other ailment this is the person that one would see. If it is determined that you need to consult with another doctor, then the primary care physician will send you to a specialist. Generally, this doctor is a part of the HMO network. Your insurance will only cover those doctors that are included within the network. Any visits to an out of network physician will result in the total bill being paid by the patient.

PPO plans do not require that you use an in network physician. You can choose a primary doctor, but you will not be required to get a referral to see another specialist. However, there are incentives that the insurance companies will offer to entice you to stay within the confines of the network. The percentage that they pay towards an in network doctor is much higher and can make your doctor choice dependent upon price instead of the quality of the doctor.

If every one of your doctors is listed in the network plan of your insurance company then you might decide to choose an HMO plan. This only requires that you pay a set fee or co-pay for each visit that you make. If you have an illness that requires you to see a specialist that is not listed, then a PPO option may be your best choice. This allows you to make a doctor visit and have some of the cost covered by your health insurance. This will help to keep your out of pocket costs down and keep money in your pocket.

Health insurance policies are offered by most major employers. It is important to read all the rules and benefits that are offered. If a plan costs less to purchase, it may cost you more in the long run if none of your doctors are included in the insurance network. Your out of pocket costs will rise and will make the total cost in having that particular insurance not affordable.