Do I Have to Pay a Deductible for an HMO?

Posted in Health Insurance , Health Insurance Claims , HMO

April 27th, 2009

When reviewing characteristics of HMOs, you may wonder whether you are responsible for paying a deductible. This is a good question, considering that some types of health insurance coverage require that you do.

What is a Deductible?

If you’re not sure what paying a deductible means in the world of health insurance, it’s not much different than with auto insurance or any other type of coverage that requires that you make some type of initial payment before receiving treatment. Depending on the type of insurance plan you take on, you may have to be responsible for a deductible, but with HMOs, this is not your responsibility. This is definitely one of the perks associated with this type of plan.

What Other Benefits Come from HMOs?

While not paying a deductible is a major advantage of HMOs, there are others:

• Low monthly payment. Because this type of coverage is limited in who you get to choose for your care (your primary care physician chooses what specialists you will work with), you get to take advantage of lower coverage, which results in a lower monthly payment.
• Low co-payments. Another benefit of HMOs is low co-payments. Typically, visits range from $5 to $20, and even emergency room visits are reasonable.

While there are numerous benefits to taking on HMOs, there are a few disadvantages as well, so it’s good to check out as much as you can about this type of coverage before signing on. But if you’ve done your research and like what you see, there’s nothing wrong with getting away with not paying a deductible.