Direct answer
It depends on whether your specialists are in the insurer’s network; a PPO typically offers more flexibility to see out-of-network providers, while an HMO often requires a primary care physician referral to see a specialist.
National Association of Insurance Commissioners guidelines on managed care network structures. For additional information about how different network structures impact specialist access, see the Healthcare.gov guide to plan types.
What this means for you
It depends on whether your specialists are in the insurer’s network; a PPO typically offers more flexibility to see out-of-network providers, while an HMO often requires a primary care physician referral to see a specialist.
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