Health Maintenance Organizations (HMOs) Explained

Health Maintenance Organizations (HMOs) are one of the oldest forms of managed healthcare. HMO’s often place more emphasis on prevention and quality of care than other types of health plans such as indemnity plans.

More opportunity to control health care costs exists in HMOs than in other types of plans, so HMO’s are typically less expensive.

If you’re in a health maintenance organization you will receive most or all of your health care from an “in-network” healthcare provider. HMOs require that you choose a primary care physician who is responsible for managing and coordinating all of your healthcare.

HMOs typically provide members with comprehensive health care services including a list of specialists that the member may see. When needed, your primary care physician will refer you to a specialist who is typically in the HMO network as well. Physicians may be employees of the HMO or the HMO may contract with independent physicians to provide care.

If you do not have a referral to a specialist, or you choose to go to a physician outside of your network, you typically have to pay most if not all of the cost for that visit.

HMOs usually charge individuals a small $10 to $20 co-payment for each doctor visit or prescription drug purchase. If the HMO is efficient and keeps its members healthy, it will make a profit.

Call Jeff Pennington today at 1-877-221-6198 to discuss your needs and get a selection of life insurance quotes for your situation. Jeff can answer all of your insurance questions and will provide friendly personal advice.

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