Not everyone finds the right fit through Marketplace plans. Some individuals prefer more flexibility, different provider networks, or alternative options that better meet their health and financial needs. That’s where private health insurance plans, including HMOs and PPOs, can provide a solution.
A Health Maintenance Organization (HMO) plan typically requires you to select a primary care physician (PCP) who coordinates all of your care. If you need to see a specialist, you’ll usually need a referral from your PCP.
Lower monthly premiums compared to PPOs.
Smaller, more structured provider network.
Best for individuals who don’t mind choosing a primary doctor and staying within a set network of providers.
A Preferred Provider Organization (PPO) plan offers more flexibility in choosing providers and doesn’t require a referral to see a specialist.
Larger provider networks with more freedom to choose doctors and hospitals.
Out-of-network care is often covered, though at a higher cost.
Higher monthly premiums compared to HMOs.
Great for people who want the ability to see specialists directly or keep their preferred doctors.
Private HMO and PPO plans may be a good fit for:
Individuals who don’t qualify for Marketplace subsidies but still want comprehensive coverage.
Those who want more control over their choice of doctors and specialists.
People who travel frequently and want broader network access.
Small business owners or professionals seeking alternatives to Marketplace options.
The decision often comes down to balancing cost and flexibility:
HMO: Lower cost, but less flexibility.
PPO: Higher cost, but more provider choice.
✨It’s important to evaluate your health needs, budget, and lifestyle before deciding which type of plan is the best fit.
At Estrella Business & Insurance Solutions, we’re here to help you navigate your options. Contact us to learn more about private HMO and PPO insurance plans and find out what coverage options may be right for you.
