HMO Health Insurance Basics

In the US, there are various types of private health insurance available. Some health insurance plans may be offered through an employer. Others may be purchased privately through an insurance provider. They cover all sorts of medical care needs for every level of care and financial ability. One type of available insurance is HMO Health Insurance.

What Is an HMO and How Does It Work?

HMO stands for Health Maintenance Organization. An HMO is an insurance organization that works with Doctors, hospitals and other health care providers to provide lower cost medical care too those enrolled. These health care professionals work within a contract to provide medical services for enrolled patients. This type of health insurance coverage is made available to individuals that work with a company of 25 or more employees. It may guarantee health insurance coverage within the guidelines of the contract.

Each member of an HMO must choose a PCP, or Primary Care Physician. This doctor will act as their main physician for all health care needs. Generally, this physician will see the patient for all medical issues and then field out any specific health care problems to specialists within the HMO. Members of this plan must always see their PCP first in order to be covered under the plan before being referred to a specialist.

An HMO May Provide Preventative Care As Well As Emergency Medical Care

We all know that it is vital that our health insurance plan covers our needs in a medical emergency. It is also extremely important that our insurance provider takes care of our preventative medical needs. An HMO may provide its members with preventative medical care, such as yearly exams and other health care programs aimed in keeping its members in good health before a health problem arises.

This may be as simple as an annual physical or as specific as prenatal classes or physical fitness programs. The benefit of these is that your HMO is assisting you in living a healthy life and preventing illness down the road. In the long run, this could save time, money and lives.