HMO Network

WINhealth’s HMO-style plan is equipped with a PPO-style network. For you, that means a dynamic combination of healthcare cost savings with a network of thousands of primary care physicians and specialists. Where the HMO component helps members save significantly because we’ve teamed with a network of physicians to lower costs, our primary network also expands to six different states to give members a vast selection of excellent medical care options.

Along with primary care doctors, we have providers in specialties including sleep medicine, nephrology, pulmonology, neurology, pediatrics, internists, radiologists, and behavioral health therapists, to name a few. We are also advancing our ancillary care provider list, which currently includes chiropractors, physical therapists, optometrists, oral surgeons and more.

It’s a powerful mix of coverage and savings that enables you to receive the best value possible from your healthcare plan.

HMO or PPO, What’s the Difference?

It comes down to cost. PPOs may provide greater access than HMOs, but the copays, premiums and out-of-pocket costs are often higher.

HMOs:

Pros:

  • Have a provider network that enables more savings for members  
  • Tend to be more affordable than PPOs

Cons:

  • May require referrals to see a specialist
  • Network may be limited and out-of-network costs can be higher

PPOs:

Pros:

  • Offer the choice to see out-of-network doctors with reduced payment
  • Often provide greater access than HMOs and usually do not require a referral to see a specialist

Cons:

  • Charge higher copays, especially for doctors who charge above “reasonable and customary rates”
  • Usually have higher premium and out-of-pocket costs than HMOs

The WINhealth Advantage

With WINhealth’s expanded network, you still receive comprehensive coverage and access to thousands of doctors and specialists within a six-state range. It’s a model that unites doctors, clinics and hospitals together to provide the care that our members need – all while controlling healthcare costs and securing savings for our members.

WINhealth’s HMO is designed with the intention of keeping people healthy and supporting them in managing chronic conditions so that they don’t experience emergencies and can maintain a better quality of life. For WINhealth, the old saying rings true: “an ounce of prevention is worth a pound of cure.”

WINhealth’s plan means choosing from a network of providers, but that network is equipped with thousands of outstanding physicians to choose from – and we’re always adding even more.