HMO vs. PPO Doctors

J.R.

Guru
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1,971
Texas
Are HMO doctors prohibited from working outside of their HMO plan.

I vaguely reading somewhere saying that PPO doctors can negotiate with any insurance carrier/network they want, but once an HMO doctor is with a carrier (i.e., BCBS, KP, etc.) they cannot have contracts with other networks and carriers. Thanks.
 
Typically a KP doc only works as an employee for Kaiser. Most other plans use independent medical groups who then contract with independent doctors.

My doctor belongs to about 6-7 HMO plans and 3 medical groups.
 
Many, but not all, HMO's have staff PCP's. Specialists are usually in private practice and contract with HMO's as well as multiple PPO's
 
I am only familiar with Medicare Advantage HMO's and I don't think any HMO at all is currently offered in my small metro area. I believe with the Medicare plans the providers are independent contractors.
 
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