HMO 101: Definition and Key Facts


If you are looking to define "HMO," then it's likely you're trying to discover what type of health insurance best suits your needs. You want to know how plans work, as well as how they can help you get the medical coverage and services that are necessary to your well-being. It is only when you are equipped with this information that you can make smart choices about your health insurance. If you need help, you can also turn to a licensed, knowledgeable representative at HealthMarkets Insurance Agency. We'll cover all of your healthcare options, including the HMO, in detail.

 

An HMO, or Health Maintenance Organization, is one of the primary types of health insurance plans to choose from. Okay, so what does that definition mean? Here are a few key facts about the HMO option:

  • With an HMO, you choose a primary care physician, or PCP, from a network of providers.
  • The PCP you choose will refer you to any specialists you need to see, also chosen from a list of in-network providers.
  • Instead of paying a deductible, HMO plans require you to pay copays for medical services. Different types of services will have different copay amounts.
  • HMOs do not cover health care services delivered by out of network doctors or hospitals.
  • While an HMO may be less flexible than other options, it may also be more predictable, which is generally a desired feature in health care plans.

Even if you decide that an HMO is the best type of plan for your needs, there are still a lot of options out there. And we can help. Tricia from Tulelake, CA, told us, “I requested a health insurance quote and received a phone call back. The agent answered all my questions and found the best plan for me. He was never in a rush and made sure all of my questions were answered.” One of the thousands of licensed, knowledgeable agents at HealthMarkets can do the same for you.

Find a licensed agent in your area, or give us a call today.

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