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Health Maintenance Organizations (HMO's)
"Managed Care"

A Health Maintenance Organization plan is the most restrictive type of managed care. Like Point-of Service and PPO's, HMO's have made arrangements for lower fees with a network of health care providers and give their policyholders a financial incentive to stay within that network.

HMO plans also utilize a gatekeeper, or Primary Care Physician. You'll need to choose your primary care physician (PCP) from among the plan's network of doctors. HMO's require that you only see their doctors, and that you get a referral from your primary care physician before you see a specialist. In most cases you'll need to get clearance before you can visit the emergence room, if your able. In general, you must see HMO approved physicians and use HMO approved facilities or pay the entire cost of the visit yourself.
HMO plans generally cover more preventive care services, and may even offer health improvement programs like workshops on nutrition and smoking cessation, and discounts at health clubs.

Is a HMO Wright For You?

HMO coverage is a trade-off between premiums paid and plan flexibility. HMO's offer some very attractive rates but are very restrictive when it comes to coverage. Rates and coverage vary form state to state so shop around on your own or talk to an independent insurance agent to make sure you get a plan that's right for you. For more information and rates on HMO's visit our specialist site below.

Health Maintenance Organizations
HMO's Specialist

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