How does a PPO differ from an HMO?

Prepare for the Georgia Health Insurance Exam. Study using flashcards, multiple-choice questions, and get ready with explanations for each question. Ace your exam!

A Preferred Provider Organization (PPO) is structured to offer members more flexibility when it comes to choosing healthcare providers. This means that PPO members can visit any doctor or specialist without needing a referral, which is often required in Health Maintenance Organizations (HMOs). This flexibility is a significant advantage for individuals who may want to see a specialist directly or who have a preferred provider who is outside of a network. Moreover, PPOs typically have a larger network of healthcare providers compared to HMOs, allowing members to access a wider range of services and specialists.

In contrast, the other options suggest characteristics that do not accurately describe the primary differences between PPOs and HMOs. For instance, while deductibles can vary significantly across different plans, it is not inherently true that PPOs have higher deductibles than HMOs. Additionally, the statement about PPOs contracting with fewer physicians is inaccurate, as PPOs generally have more participating providers to broaden their network. Lastly, the idea that PPOs primarily cover emergency services while HMOs do not misrepresents how both plan types function; both generally cover a variety of medical services, including emergency care.

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