What Do PPO, HMO and HMO-POS Mean?

You've probably noticed a lot of acronyms while shopping for Blue Cross Blue Shield of Michigan Medicare Advantage plans. PPO, HMO and POS — all of these are different plan types.

Here's what they mean:

  • PPO stands for preferred provider organization.
  • HMO stands for health maintenance organization.
  • POS stands for point of service.

All these plans use a network of doctors and hospitals. The difference is how big those networks are and how you use them.

PPO plans

PPO plans have more flexibility than HMO plans. Your plan doesn’t require you to choose a primary care phyician. You can see doctors inside or outside your network. But if you stay in your network, you’ll pay less. This means you can travel domestically without worrying about whether you're covered.

You have to live in Michigan for at least six months out of the year to get one of our PPO plans.

HMO plans

When you have an HMO plan, you choose a primary care physician who works as your partner. They coordinate all your care and can refer you to trusted doctors and specialists in your network.

It's important to remember that most health care isn't covered outside your network with an HMO plan. That means if you're traveling outside your coverage area, we'll only cover emergency or urgent care in most cases.

You have to live in Michigan for at least six months out of the year to get one of our HMO plans.

HMO-POS plans

HMO-POS plans work a lot like HMO plans. The main difference is that you can see doctors outside your network in some cases. That's where the POS, or point of service, part comes in. You still need to choose a primary care physician who coordinates your care though. 

With our HMO-POS plans, you can get routine health care when you travel nationwide.

You have to live in one of these 70 counties in Michigan for at least six months out of the year to get one of our HMO-POS plans. 

Which plan type is right for me?

If you want to be able to coordinate your own health care, a PPO plan might be right for you.

If you want low monthly premiums and copays and you don’t travel much, an HMO plan might be right for you.

If you travel often within the U.S. and you want one doctor coordinating your care, an HMO-POS plan might be right for you.

All our Medicare Advantage plans help cover emergency care outside the U.S.

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