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HMO Health Plans

Likely you have heard of HMO Health Plans, but what exactly are they and are they right for you? HMO, also known as Health Maintenance Organization, is an affordable health care policy that has a fixed monthly rate for the life of the insurance coverage. You are given a network of physicians to choose from, so you must only work within the network. Not every physician and hospital will accept HMO health plans. Once you choose your primary health care physician, he/she will be responsible for your medical needs.

Your physician will also make referrals to other specialists for you to see for medical treatments you need to have done that can’t be achieved by him/her. You won’t be able to see anyone else or receive medical treatment within your coverage unless you have a referral from your physician.

It is required of you to make co-payments for treatments. Anytime you receive medical care from a physician outside of the HMO’s network, you will not be covered by the policy. Many people look to HMOs because they require little or no paperwork and are very affordable without sacrificing preventative medical care options. You are required to pay a flat-rate monthly premium as well as co-payments for services. It is a good idea to check around for the best priced HMO policy out there before going with any that you may find.

Make sure to ask questions before getting HMO coverage:

  • How many doctors will I be able to select from?
  • Are the physicians on the list group and private practice?
  • Which of the doctors are accepting new patients?
  • Is it easy to change my primary care physician?
  • Is the appointment setting quick?
  • What medical services are covered?
  • What do I do if one of the services I need isn’t covered by the plan?
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