Honestly, the actual thing you need to check is the benefit structure of the insurance plans. You need to see which medications are on the formulary, covered conditions, procedures, etc. See if your doctors or hospital system are in the network, or if it will be incredibly difficult to stay in-network in your area. Nobody wants to be in the situation where they have to travel to another city in order to go to the ER or even a regular check-up.

My wife’s BCBS PPO has been ungodly great for my trans care. My bottom surgery didn’t cost a dime and my meds are well covered.

HMO stands for Hand the Money Over

If you live in a US blue state I think the HMO will be fine. Otherwise you should probably figure out which local hrt provider you will want to use and see if they will work with your insurance.

In my experience, PPOs are nearly as restrictive as HMOs, but far more arcane.

I have had many experiences where in attempting to see a doctor, I find one that seems to accept my insurance, only to later discover that they only accept the platinum plan, and I'm on the Platinum PLUS plan, so actually none of my visits were covered.

With an HMO (I had kaiser, which was by far the best healthcare I've ever had) shit was obvious. You got treatment from the HMOs offices, and you were covered.