Being able to choose your doctor is a luxury that insurers will make you pay dearly for.
According to new research from the Kaiser Family Foundation, the cost of preferred provider organization health plans, which allow consumers broader freedom in picking physicians, specialists and hospitals, are less and less common and more and more expensive than in the past.
HMOs dominate on the federal Obamacare insurance exchange. Kaiser's analysis of policies offered in states whose residents must buy insurance through Healthcare.gov found big price differences between silver-level PPOs and silver-level HMOs. More importantly, the price difference between the two is getting greater.
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The average cost of the cheapest silver-level HMO will increase 9 percent — from $274 to $299 a month — while the mean cost of the cheapest PPO is increasing 17 percent, from $291 to $339 a month.
A woman seeking a plan on the federal exchange in Plymouth, Indiana told Kaiser only two of the 75 plans available to her were PPOs, and the only one provides decent coverage at two hospitals her family wants access to. But the $1,109 premium a month is more than double the cheapest plans on the exchange.
In many places, PPOs simply aren't available anymore. In Houston, the fourth largest city in America, there will be no PPOs offered through the federal exchange.
Jo Middleton, a Houston insurance broker, described the challenges consumers face in the area: "Everyone is up in arms," she said. "I do not have a single client who is happy. They want PPOs and can't get them. They want the flexibility."
"If you are someone who needs several doctors and several specialists, it's difficult to find a network they are all in," she added. "In many cases, the doctors may be in a network, but only have admitting privileges at a non-network hospital. In the 11 years I've been in the business, this is unprecedented."
A broker in Arizona tells Kaiser that the differences between PPOs and HMOs is "starting to blur" as some PPO plans begin requiring policyholders to get approval before choosing a doctor.
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