The short and sweet of it is that HMOs are very restrictive and want you to remain in their “network” - which means you need a Primary Care Physician who participates in the network with them.  Such a physician has signed paperwork saying they will follow the insurance companies rules, only refer you where the insurance company says, and receive payment when they bill your insurance of a set rate.

On the other hand, PPOs are flexible.  They allow you to go “out-of-network” - including not only any specialist you’d like to see but also any primary care doc!  That’s why we encourage patients to check their insurance plan before joining our practice.  If your plan is an HMO, it lets us (as out-of-network doctors) to care for you as you and we see fit.  The gist is that we can see you, you can see who you want, and we are only paid by your monthly membership fee to be part of the practice.

If you’re a patient who has lots of specialists and needs help with coordination, likes the idea of a doctor who is not “on the hook” with the insurance companies, or just plain likes the idea that you can choose who you’d like to see - a PPO plan alongside a DPC doctor - like us at Balanced Physician Care! - might be the perfect match for you.  And no it's not paying twice for healthcare, we think it’s making a smart choice for your health!  For more on how we practice primary care differently in Jacksonville, FL, check us out at BalancedPhysicianCare.com