Provider:
Describes a hospital or healthcare facility, physician or medical professional that offers or provides healthcare services.
PCP (Primary Care Physician):
Describes a physician or medical professional that is more commonly known as a primary care provider, personal care physician or provider.
PPO (Preferred Provider Organization):
Describes the member or network of approved hospital/doctors to use.
- Typical to have an annual deductible and may have a co-pay per visit/service.
- Referrals are usually required for specialty care
- Medical treatment from outside of your network will generally come with higher out-of-pocket expenses.
HMO (Heath Maintenance Organization):
As a member, you are required to select your primary care physician from the HMO network.
- Referrals for specialty care must be made within the HMO network and obtained from your PCP.
- Care without a referral or from outside of your network may not be covered (except for ER care).
- May or may not have co-pay per visit/service and are not responsible for paying a deductible.
- If you utilize the doctors and hospitals within your HMO network, you should have little out-of-pocket expenses.