HMO vs. PPO: Which is Better for Medicare?

What is better, an HMO or a PPO? If you're buying a Medicare Advantage plan, there's more options available than those two, but those two are by far the most popular options. But there's, there's some other types. Most people don't know the difference. And they're like, ah, they both in your area, typically I'll have a plan that's $0 a month. So there's a $0 a month HMO. And there's a $0 a month PPO and might be with the same insurance company. But you're like, well, they're both $0 a month. So I, whatever you don't, you don't really look into how the plans are built. With an HMO, it's a more restrictive network. You, you have access to fewer doctors and fewer hospitals. So by giving up that flexibility, they give you richer benefits. You might have lowered co-pays, a lower maximum out-of-pocket and richer extras, more dental, more vision, more hearing. So with an HMO, if you got cancer and you stayed in network, you could have the lowest maximum out-of-pocket. So if you got cancer and pay the least, if you stayed in that network. Now, the reason I prefer PPOs is because you don't know what you're going to get sick with. And I've been doing this for 30 years. So I've had clients that are wildly healthy. At 65, they take no medications. They play in senior tennis leagues. They mow their lawn with a push mower. They're very active. And then five years later, they call me and they have some crazy rare disease. And I can think of a lot of these clients through my past. And one lady, she got a So strange, but she had to go to her only chance of survival was to go to this specialist way out West. So five States over her husband had to take off work and pay for hotel, get there. It was a lot of money. Now the kicker was she had a Medicare advantage PPO. So with the PPO, you can go out of If she had an HMO, you can go wherever you want, but you'll be paying for it. If they're not in your network and your network is going to be close to home. So it's rare to find a plan that has a nationwide network, even though there are a few plans that do that. Most HMOs, the reason it's so cheap, the reason you have the lowest premiums, the lowest Dr. Copays, the lowest in-hospital the lowest maximum out-of-pocket and the richest extra benefits because you're giving up that flexibility to see many doctors. So if you're really healthy and you expect to be healthy, or you accept that if I get sick, I'm just going to stay with the doctors in this hospital, then that might be a really good plan for you. But for most people, a PPO is not that much more zero. But for example, it might cost me $10 to see a doctor with an HMO. It might cost me $20 with the PPO. So it might cost me $200 if I go into a hospital for one night, it might cost me $400 if I go in one night. So everything's going to be a little bit higher if you put them side by side. And the big one being the most you could pay in a year, your maximum out-of-pocket for the PPO, it's going to be a lot more than an HMO. Let's just leave it right there. So if you're buying insurance, like I want you to, if you follow me at the Medicare family, I want you to buy insurance for the future for the what if not for right now when you're healthy and you don't use it. And so I'll just go with the cheapest thing and then live to regret it later. Buy the best insurance you can afford, whether it's an HMO, a PPO, a Medicare supplement plan or a plan N. You have a lot of different choices as well, but buy the insurance for the what if, not necessarily for the what is going on today, but for more in-depth help with your unique personal Medicare needs, we need to talk to you personally. What's going on in your life, your budget, your marriage, are you moving, your health, the drugs you take. When you book an appointment with our team, TheMedicareFamily.com, it's a little yellow box on our website. Book your own appointment. Our services are free. You don't have to worry about that, but we're going to talk to you about different options that are available. Ask you a lot of private questions to help give you advice and explain to you the different ways you could go. Ultimately, you're making the decision and we're just here to guide you. We're licensed in all 50 states. If you need our help, be sure to go to our website, TheMedicareFamily.com. We'd love to help If you like this video, you might really like this video. Check it out. And we'd appreciate if you subscribe to our channel so you never miss a great video. We put out one every week. Check in the description below this video for a link to our cheat sheet on Social Security and Medicare. And you can also give us a comment. If you have a specific question, always feel free to call us or email us at TheMedicareFamily.com.