08/27/2026
🩺 HMO OR PPO — WHICH ONE FITS YOUR HEALTHCARE NEEDS?
Learning about HMO vs. PPO can help you understand how to use your health insurance, where you can receive care, and how to avoid unexpected costs.
Having an insurance card is only the beginning. Knowing how your plan works is just as important.
🟢 HMO — Health Maintenance Organization
HMO plans generally require you to receive care within the plan’s network. You usually have a Primary Care Physician (P*P) who coordinates your care. Many specialist services may require a referral or prior authorization.
🔵 PPO — Preferred Provider Organization
PPO plans generally offer more flexibility when choosing doctors and specialists. Referrals are typically not required to see specialists. Some PPO plans provide out-of-network benefits, but your costs may be higher.
💳 WHERE CAN YOU FIND YOUR PLAN INFORMATION?
Start with your health insurance ID card. Depending on your plan, it may show:
• Plan or network name
• HMO or PPO plan type
• Member ID and Group Number
• P*P information
• Copays
• Pharmacy/Rx information
• Member Services phone number
⚠️ Before receiving care, verify your benefits. Your insurance card does not show every benefit or requirement. Check your insurer’s member portal or plan documents, or call Member Services to confirm your network, referrals, prior authorization requirements, and costs.
❤️ Know Your Plan • Know Your Network • Use Your Benefits Wisely
PORAMA SRIJINDA
Life & Health Insurance Agent
CA Life & Health Lic.
📞 (619) 200-5296
For general health insurance education only. Benefits, networks, referrals, authorizations, and costs vary by plan. Always verify directly with your health plan.
