Explain the difference

[LowlyPremed]

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Please explain the difference between HMOs, PPOs, and Third-Party Providers. I have lots of information on HMOs but I can't seem to find anything on PPOs and Third Party Providers. If you have a link please provide.
Thanks!

 

[nutmegs]

any company paying for your heathcare that isn't you is a 3rd party provider. (you are party #1, your healthcare provider is party #2). as far as PPO it is "preferred physician" and I believe they will cover a percentage of the cost for an out-of-network doctor, as opposed to an HMO which gives you a list and covers 0% of out-of-network places.

 

[kimmcauliffe]

any company paying for your heathcare that isn't you is a 3rd party provider. (you are party #1, your healthcare provider is party #2). as far as PPO it is "preferred physician" and I believe they will cover a percentage of the cost for an out-of-network doctor, as opposed to an HMO which gives you a list and covers 0% of out-of-network places.

That's pretty much it. HMOs are tricky because you can only see one of the providers that they list for you. Ah the joys of being an insurance clerk at one point in my evil life.