Two of the most common types of health insurance plans are HMOs and PPOs. The type of plan you choose may affect which doctors or specialists are in your network.
The difference between an HMO and a PPO plan
Provider networks are different for HMO and PPO plans:
- HMO: With traditional HMOs, you need to use a specific provider network and choose a primary care doctor. Some HMOs may require a referral from your primary care doctor before you can see a specialist.
- PPO: With a PPO, you have a network of preferred providers. You are typically able to choose any doctor or specialist without a referral if they are in the PPO network.
Both HMOs and PPOs can be “open access”. This means you can choose to see an out-of-network provider without a referral, but you’ll pay less when you get care from a doctor in the HMO or PPO network.*
What does Blue Cross offer?
Blue Cross offers open access PPO plans to employer groups.
Blue Plus is a licensed nonprofit HMO. It is an affiliate of Blue Cross and Blue Shield of Minnesota. Blue Plus HMO plans are available to people who qualify for Minnesota medical assistance. These plans can help you pay for health care if you have limited income or a disability.
Blue Plus members in a Minnesota health care program must choose a doctor from the Blue Plus network, or one will be assigned. These Blue Plus plans are open access, which means members can select any primary care physician or specialist in the network and do not need a referral. In some instances, out-of-network care is allowed.
More about understanding health plans
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Connect with a Blue Cross Advisor