HMO Health Insurance Plans

Health Maintenance Organization plans (HMOs) are typically the most affordable kind of health insurance you can buy.

HMOs are managed care plans. That means you receive care from a “network” of health care providers. In other words, HMO health insurance covers the medical services of a large group of doctors, hospitals, specialists, and clinics.

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The biggest advantage of HMO plans is their low cost. They feature low monthly premiums and copayments for care. And most HMOs won’t require you to meet an annual deductible.

Many HMO plans provide comprehensive health insurance benefits — with coverage for services such as preventive care, emergency and hospital care, specialist care, outpatient surgeries, and prescription drugs.

Using Your HMO Health Insurance

If you need to see a doctor for a routine health check-up, you’ll usually be responsible for a copayment for the visit. A copayment for a doctor’s office visit can be as low as $10.

You won’t have to make a claim — just show your HMO health insurance card, make your copayment, and the rest will be taken care of for you. Avoiding all the extra paperwork is another big plus for HMO health insurance.

One important thing to remember about HMOs: you only have coverage with in-network providers. Your plan won’t pay for any care received from a doctor that doesn’t participate with your HMO.

Luckily, most HMO networks include thousands of health care professionals. So finding a doctor or hospital that’s conveniently located usually isn’t a problem.

Choosing a Primary Care Physician

With an HMO plan, you’ll have to choose a Primary Care Physician (PCP). They’ll be your “first-line-of-defense” doctor — the first place you go to for medical care.

If you need to see a specialist or another physician, your PCP will need to give you a referral. Without this referral, your HMO health insurance plan won’t cover that care.

What kinds of doctors can be considered as a PCP?

  • Internists
  • Family doctors
  • Pediatricians
  • OB/GYNs

Compare Your Options Before You Decide

Want to see how HMOs stack up against other kinds of health insurance plans? Use our Instant Quote Service. You’ll be able to compare rates and benefits on several kinds of plans offered by the nation’s leading insurers.

You can also get competitive quotes from local agents, or speak with an agent on the phone right now.