HMO Basic Facts

If working with an HMO is your preference for health insurance, you may want to check out some basic facts about it before applying for coverage. This way, you won’t feel obligated to take on coverage that you dont think youll truly benefit from.

What is an HMO?

HMO stands for Health Maintenance Organization. It offers comprehensive coverage, which includes doctor’s visits, surgery, emergency care, hospital stays, x-rays, therapy and more.

HMOs were created as a way to provide preventative treatment. As a result, patients are able to take advantage of immunizations, mammograms and physicals.

What are the benefits of an HMO?

This type of coverage comes at a lower monthly cost than other types of health insurance. If you go with an HMO, you have to work with one primary care physician who will be responsible for assigning all other care givers to you. The only exception to this rule is the emergency room visit, or going to the OB/GYN.

How much do HMOs cost?

Your co-payments are usually lower than with the PPO or POS somewhere in the ballpark of $5 for primary care visits, $15 for specialist visits, and $25 for emergency room visits. No deductibles are required.

What are the drawbacks of HMOs?

This type of health insurance may not be available everywhere. If you live in a remote area, there may be few or no physicians that work with an HMO. While the coverage is considered comprehensive, there are some services that may not be covered. These are determined by individual HMOs.

Judging by the list of facts above, there are both pros and cons to joining an HMO. So if you’re not sure this type of health insurance coverage is right for you, theres no harm in looking at the PPO or POS to see if they more closely match your needs.