Health Maintenance Organization (HMO) is a health insurance coverage that is provided by a managed care organization. The HMO organization contains at least 25 employees. There are various types of HMO organizations including staff model and group mode. In staff model, the HMO organization will employ and pay the physicians a salary. The group model has contracts with independent physicians.
The HMO plan is made available in the workplace. It is preferred by the employees because of its low cost and attractive benefits. There are a wide variety of physicians you can choose from. The members are required to pay a copayment that ranges from $15 - $20 per visit. HMO plan does not charge an annual deductible. The HMP copayment cost is cheaper compare to the PPO.
When you apply for a HMO plan, you will be asked to choose a primary care physician (PCP). If the primary care physician is unable to treat a medical condition, he or she will refer the patient to a specialist. If you choose to see a specialist without getting permission from a PCP doctor, you will have to undergo a pre-approval process.
It is important to check the coverage and features of a HMO plan before you apply for it. Some of the things that you should take into account when applying for a HMO plan include how long is the pre-existing medical conditions coverage and the coverage cost for expensive surgical procedure such as heart transplant, bone marrow transplant and etc.
