How to Evaluate Group Health Insurance HMO & PPO Plans

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You should always try to evaluate health insurance plans as thoroughly as possible before deciding on one. Evaluate group health insurance HMO and PPO plans with help from the president of The Stratford Financial Group, Inc. in this free video clip.

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Video Transcript

Hello, I'm Jeffrey Ingalls; President of Stratford Financial Group and Stratford Employer Services in Wayne, New Jersey. And right now, we're to talk about how to evaluate group health insurance HMO and PPO plans. In order to evaluate both plans, you need to perform a series of comparisons and equations to determine which plan is the best and right fit for you. The first equation would be a network equation. You need to determine the listing of participating providers under the HMO as well as the listing of participating providers under the PPO and see which will best accommodate you. Next, you need to perform a value equation. The PPO plan will provide out of network benefits and you need to determine or evaluate the likelihood of needing those out of network benefits under that plan designed. Secondly, you need to determine the differences if any in the actual coverage or coverage services under the HMO versus the PPO. Next, you'll need to perform a financial equation. And to do so, you'll need to determine your likely out of pocket under the PPO plan as well as the HMO plan. So again, you want to take a look at the deductibles, copays, co-insurances and maximum out of pockets associated with each plan to enable you to do so. Once determining your likely out of pocket under each plan, you want to add that figure to the premium or employee contribution required for the PPO versus the HMO and determine which plan would be the best financial fit over the course of a given year. By asking yourself these questions and performing these equations, the right choice, HMO or PPO should become clear. My name is Jeffrey Ingalls. I'm the President of Stratford Financial Group and Stratford Employer Services in Wayne, New Jersey. We can be found online at www.stratfordlink.com and you just watched how to evaluate group health insurance HMO and PPO plans. Thank you.

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