Understanding the difference between Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO) health plans can help you choose the right coverage. Here's a brief overview to get you started.
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Health care can feel complicated. We’re here to help make it simpler to understand.
ON-SCREEN TEXT: HMO vs. PPO
When you’re reviewing health plans, you may wonder about the difference between an HMO and PPO.
They’re both network-based health plans, and their names sound similar. But they work a little differently.
Let’s dive into it.
ON-SCREEN TEXT: Health
Maintenance
Organization
maintain your health.
ON-SCREEN TEXT: Preferred
HMO is short for “health maintenance organization.” That name refers to the plan’s overall goal — to help
Provider
Organization
PPO stands for “preferred provider organization,” named after its network of preferred providers who offer
care at a lower out-of-pocket cost.
ON-SCREEN TEXT: Cost
Flexibility
But more important than their names are how these plans work. The key differences between HMO and
PPO plans come mostly down to two things — cost and flexibility.
ON-SCREEN TEXT: HMO plans
Lower premiums
Lower out-of-pocket costs
Stay within network
HMO plans typically offer lower premiums and out-of-pocket costs. But you need to stay within the
network to receive coverage. If you get care from an out-of-network provider, you’ll pay the full cost of that
service.
ON-SCREEN TEXT: PPO Plans
Larger network
Out-of-network providers
Flexibility to go outside of the network
PPO plans tend to offer a larger network of providers, and you even can see providers outside the
network. You can save money when you stay in network, but you have the flexibility to go outside the
network.
ON-SCREEN TEXT: Specialty care
© 2025 United HealthCare Services, Inc. All Rights Reserved. 1The two plans also differ in how you obtain specialty care. With HMO plans, you’ll go through your
primary care provider for a referral to see specialists.
With a PPO, most plans allow you to see a specialist without a referral.
ON-SCREEN TEXT: Lower costs
Limited network
Flexibility
More choice
So, when you think of HMO plans, think lower costs but a limited network. When you think of PPO plans,
think flexibility and more choice.
ON-SCREEN TEXT: Which plan is right for you?
Choosing between an HMO or a PPO plan comes down to what matters to you.
ON-SCREEN TEXT: A PPO plan might be right for you
Do you like the freedom to choose your own doctors and specialists? Do you want to make sure you have
coverage, even if you go outside the network? Then a PPO plan might be right for you.
ON-SCREEN TEXT: An HMO plan might be right for you
But if you’d like to control your costs with lower premiums, don’t travel much and typically don’t see
specialists, then an HMO plan might be a good fit.
ON-SCREEN TEXT: What’s the monthly premium?
Is there a deductible?
Are my doctors in network?
What are out-of-pocket costs?
What is my emergency coverage?
HMO
PPO
Before you enroll in any health plan, it’s a good idea to look at all the plan details. What are your monthly
premium costs? Is there a deductible to meet? Are your doctors in network? What are your out-of-pocket
costs? How are you covered for emergencies? There’s a lot to consider.
ON-SCREEN TEXT: HMO vs. PPO
But knowing how HMO and PPO plans differ might give you a clearer picture when it’s time to choose
your next health insurance plan.
ON-SCREEN TEXT: uhc.com
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© 2025 United HealthCare Services, Inc.
© 2025 United HealthCare Services, Inc. All Rights Reserved. 2
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