HDHP vs. PPO and HMO

Is an HDHP REALLY for Me?

Not sure if participating in an HDHP (High Deductible Health Plan) is right for you? Weighing the options between an HDHP and an HMO? Here are a few questions you might want to ask yourself:

Do you prefer to pay a set amount when you see the doctor?
In an HDHP, you will pay the full cost of your doctor appointments until you meet the deductible; once you do, all covered medical expenses will be paid by your insurance, or you may be responsible for a small co-insurance cost. This is very similar to PPO plans, except the co-insurance is usually less and the deductibles are higher with an HDHP. If you elect to have HMO coverage, you typically pay a co-pay for all covered medical procedures.

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Do you mind paying a deductible before benefits are paid?
With HDHP coverage, your deductible is higher than under a PPO coverage option. In the HMO, there is no deductible to meet before benefits begin (though a copayment does apply to most covered services).

Do you want to take advantage of the potential tax savings available through your participation in a Health Savings Account?
You may participate in a Health Savings Account only if you elect HDHP coverage.

Do you need flexibility in terms of which physicians you can see?
With the HDHP coverage option—as in the PPO coverage options—you can see any doctor you choose, but benefits are payable at different levels depending on whether the doctor is a member of the network of participating providers. In the HMO, you must select a primary care physician (PCP), who then coordinates all of your care, including care provided by a specialist. Benefits are only payable if you see your PCP or other HMO physicians to which your PCP provides a referral.

HDHP Benefits
Read about the benefits of a high deductible health plan. Learn more about how your HDHP works!

HDHPs and HSAs
Learn how high deductible health plans work with health savings accounts.

HDHP News
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