scoobysnacx

This is giving me a headache!

So it's time for me to pick healthcare in Los Angeles and I have the choice of HMO, HRA and PPO with Blue Shield of California.

My gut feeling is PPO is best as I get to chose doctors etc, but it costs quite a bit.

I will be travelling out of state quite a bit if that makes a difference.

Bob

What ever you feel comfortable with....and whatever has best out of state coverage and out of network coverage.

I don't really see the benefit of the extra cost in a PPO over HMO, who cares if you have to see your GP/PCP first, but if that's what you prefer...though with HMO, you'll know what is and isn't covered, whilst with a PPO you'll sometimes have to pay in advance and then get reimbursed and that's when you find out you might not be entirely covered.

md95065

It is impossible to generalize about which of these is better.

It depends on exactly what each one of them covers, how much it costs, what you want and are willing to pay for, and the extent to which you expect to need any particular medical services over the next 12 months ...

Mummy in the foothills

It depends on what is available near to where you live/work. We dropped the HMO after the kids were born, I hated the 45 min to 1 hr drive to the doctors (Kaiser) and sitting on hold on the phone for an hour to make appointments and switched to a PPO where I can use doctors and dentists who are more local, we also liked the doctors offices and service better with the PPO as we didn't get much choice in who we see with the HMO.

Michael

Even though Blue Cross/Blue Shield is nationwide, each state operates independently and the companies are likely owned by different corporations. Some are for profit organizations and others are non profit organizations.

Your network provider list can possibly be only for the state in which you reside which means you may be required to use an out of network provider when out of state. Check with your plan administrator to determine if the nationwide provider list is available to you to pay the lowest co-pay. If it is, then there is an advantage of a PPO since you could use in network providers wherever you travel similar to AETNA which has a national provider list.

On the other hand, an HMO generally only has local providers that are in network and you would likely have to pay a higher co-pay/deductible when using a provider that is out of state.

Personally I always selected the PPO option (usually AETNA) since I didn't want the hassle if I needed to see a doctor outside my local area and the companies usually had flexible benefits plans which allowed me to not pay anything out of pocket for my health insurance premiums as long as I reduced the amounts of other benefits.