An HMO is a Health Maintenance Organization that covers services solely by providers within their specific network. A Primary Care Physician (PCP) is required, the PCP is responsible for coordinating all medical care and makes referrals to in-network specialty providers.
A PPO is a Preferred Provider Organization that has a network of providers but also allows use of medical providers outside of the plan’s network, typically with greater employee cost sharing. A PPO is generally more flexible than an HMO, as a Primary Care Physician (PCP) and referrals for specialty providers are not generally required.