HMO vs PPO Insurance for Prostate Cancer

PCRI's Executive Director, Mark Scholz, MD, explains the differences between HMO, PPO, and Medicare, especially as it relates to receiving care for prostate cancer.

:19 There are three different types of medical insurances: Prepaid/HMO, Private/PPO, and Medicare, which functions like private insurance.

:30 HMO insurances are insurance companies that employ physicians. It is a good economical choice for common health problems; however, for rarer medical issues, like cancer, HMO's tend to be pretty bad since they are principally concerned with cutting costs.

1:15 Those with PPO insurances have more freedom choosing their doctors, treatments for rare conditions are better funded, and there is generally better access to quality care.

1:26 Medicare functions like a PPO, although some people choose to sign over their medicare for an HMO type system. This results in benefits like better drug prices, but it also places restrictions on which doctors you can see and what treatments you can undergo. More expensive cancer treatments may require pre-authorization. With medicare, like a PPO, doctors, and patients both have more discretion.

1:58 Most men with prostate cancer are over 65 and thus have access to medicare. It's important for them to carefully consider the risks and benefits of switching to the HMO style system since it means giving up the freedom to choose their doctors and treatments.

Don’t know your stage? Take the quiz: Visit http://www.prostatecancerstaging.org

To learn more about prostate cancer visit http://www.pcri.org

To download the free Staging Guide visit http://www.pcri.org/prostate-cancer-s...

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The Prostate Cancer Research Institute (PCRI) is a 501(c)(3) not-for-profit organization that is dedicated to helping you research your treatment options. We understand that you have many questions, and we can help you find the answers that are specific to your case. All of our resources are designed by a multidisciplinary team of advocates and expert physicians, for patients. We believe that by educating yourself about the disease, you will have more productive interactions with your medical professionals and receive better-individualized care. Feel free to explore our website or call our free helpline at 1 (800) 641-7274 with any questions that you have. Our Federal Tax ID # is 95-4617875 and qualifies for maximum charitable gift deductions by individual donors.

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  Insurance and Cancer