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Started By
Message
HMO vs PPO
Posted on 7/22/14 at 3:43 pm
Posted on 7/22/14 at 3:43 pm
Here's the deal
26 single (in a serious relationship she has insurance )
Company is offering health insurance (small business ) blue cross blue shield .
I haven't been to the doc in 3 years and am not on any medication .
HMO is obviously cheaper , but is it worth it ? . PPO is about 5.5 times more per pay period than HMO . Deductible for HMO is 6k vs 3k for PPO
To piggy back , would HMO be ok for dental ? PPO is capped at 1000$ I'm going to need about 2k worth of dental work and HMO is not capped .
Thanks !
26 single (in a serious relationship she has insurance )
Company is offering health insurance (small business ) blue cross blue shield .
I haven't been to the doc in 3 years and am not on any medication .
HMO is obviously cheaper , but is it worth it ? . PPO is about 5.5 times more per pay period than HMO . Deductible for HMO is 6k vs 3k for PPO
To piggy back , would HMO be ok for dental ? PPO is capped at 1000$ I'm going to need about 2k worth of dental work and HMO is not capped .
Thanks !
4
Posted on 7/22/14 at 3:46 pm to BearCrocs
usually dental is separate coverage in most cases that I'm familiar with
does the cheaper one allow you to contribute to an HSA?
does the cheaper one allow you to contribute to an HSA?
Posted on 7/22/14 at 4:16 pm to BearCrocs
quote:
26 single
quote:
I haven't been to the doc in 3 years and am not on any medication .
HMO.
The $3K difference in deductible isn't meaningful in your situation unless you have an emergency or significant procedure or hospitalization. You still get BCBS rates for all your elective/medical services as you pay towards that deductible, and anything preventative is covered at 100% due to Obamacare anyway.
The PPO is more convenient for quick access (i.e. no referrals), but if you don't anticipate being referred to a variety of specialists this year, then getting 1-2 referrals isn't difficult. The network should be the same, so you'll still have access to whomever you want, you'll just have to coordinate the referral for the HMO.
Your total outlay for the year will be much less for the HMO than the PPO, assuming you don't have something significant or catastrophic occur.
I would suggest establishing a PCP if you get the HMO. Even if only for an annual physical. It will be covered at 100% and will also make any future referrals much easier.
Posted on 7/22/14 at 4:38 pm to MSMHater
Thank you .
What about dental ?
As I stated , I will need extensive dental work including root canal this year and PPO is capped at 1,000$
HMO is not .
What about dental ?
As I stated , I will need extensive dental work including root canal this year and PPO is capped at 1,000$
HMO is not .
Posted on 7/22/14 at 5:08 pm to BearCrocs
quote:
As I stated , I will need extensive dental work including root canal this year and PPO is capped at 1,000$ HMO is not .
I'd really need to look at the dental benfits they are offering you. I rarely see medical policies cover dental procedures like crowns and root canals. The "dental" on medical policies is usually for oral surgery. I could also see it covering your annual cleaning and xrays every few years.
But for the most part, dental plans suck, or are at least of minimal help. You will still be paying about 80% of charges on that root canal. Look at the dental benefits outlined in the package your employer gave you. If you see any coverage for crowns/root canals, take it. It will probably be minimal, but at least it would be something. But reaching that $1000 cap with the insurer only paying 20% at a time would be ALOT of dental work. And by then, you would be REALLY tired of going to the dentist.
This post was edited on 7/22/14 at 5:10 pm
Posted on 7/22/14 at 5:49 pm to MSMHater
I actually found HMO is better for me than a PPO
Posted on 7/22/14 at 6:44 pm to BearCrocs
HMO vs. PPO
Sorry, didn't note that you work for a small business rather than the state. This link might not be applicable.
Sorry, didn't note that you work for a small business rather than the state. This link might not be applicable.
This post was edited on 7/22/14 at 6:49 pm
Posted on 7/23/14 at 8:20 am to BearCrocs
Without knowing all the details, it sounds like HMO without dental is the obvious choice. How much will each one cost?
We have the BCBS PPO, which includes a "Dental Discount Plan". All that does is have a list of discounted fees and a list of dentists who have agreed to accept those fees for BCBS customers. I think the discount is applicable to all BCBS customers (HMO or PPO).
For the most part, dental insurance sucks and you will lose money with it even in years where you do get work done.
We have the BCBS PPO, which includes a "Dental Discount Plan". All that does is have a list of discounted fees and a list of dentists who have agreed to accept those fees for BCBS customers. I think the discount is applicable to all BCBS customers (HMO or PPO).
For the most part, dental insurance sucks and you will lose money with it even in years where you do get work done.
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