What is HMO
HMO Health Insurance is a Health Maintenance Organization. It is a form of health insurance in which members prepay a premium
for the HMO's health services. The HMO is the legal entity that assumes responsibility for health care services and for the cost of the insured's care.
As an HMO member, you pay a monthly premium. In exchange, the HMO provides comprehensive care for you and your family, including doctors' visits, hospital stays, emergency care, surgery, lab tests, x-rays, and therapy.
What is HMO
This type of health care plan provides a range of health care services to its insured members. An HMO contracts with health care providers, physicians, hospitals, and other health professionals. This is why HMO members are required to use participating providers in the HMO network, which are coordinated by a primary care physician selected by the insured from a list of providers.
HMOs usually require members to pay for part of their care. Members may pay a fixed amount, called a co-payment, for each service they get. The HMO may also have a yearly deductible. This is the amount members have to pay each year before the HMO pays for any services. Co-payments and deductibles help keep the cost of health care down. If members have to pay part of the cost of a service, they are not as likely to get services they do not need.
HMOs also require members to get approval before the HMO will pay for some services and treatments. This usually means that members have to get a referral from their primary care doctor or an approval from their HMO. If members get services without a referral and approval they may have to pay for the service themselves.
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