What is HMO Insurance?

There are many different options facing you when you decide to buy health insurance. One of the major options will require you to choose between an HMO (health maintenance organization) provider and a PPO (preferred provider organization). Understanding the difference between the two types of coverage will help you get the treatment options you require.

Network of Providers

An HMO uses a network of providers to provide insured patients with care. This network is predetermined by your insurance company and, for covered treatment, you are restricted to visiting only the doctors and facilities within the network.

Preventative Care

HMOs stress preventative care measures. They encourage regular visits to your primary care physician in order to treat illnesses before they become worse and more expensive.

Co-Payments

When you visit a doctor or other health care facility, you will be required to pay a co-payment between $5 and $100. The co-payments are predetermined and are printed on your insurance policy and card.

Deductibles

HMO policies can come with or without deductibles. Deductibles are set amounts of money that must be paid out-of-pocket by a policy holder before the insurance policy will begin covering treatment costs.

Out-of-Network Visits

When you have an HMO plan, you will get no reimbursement if you visit a doctor or health care facility outside of the network.