What is an hmo insurance plan?

Answer 1

HMO is one of three managed care health insurance systems in the United States. An HMO is designed to offer financial support and medical treatment to plan members. Some managed care systems don't offer medical treatment themselves. Rather, they offer different levels of financial coverage based on whether you visit in-network or out-of-network care providers. HMOs, on the other hand, have a system of physicians and hospitals that are involved in a specific coverage structure. If you're part of a Health Maintenance Organization, you are only covered if you go to a physician within the HMO network.

HMO members pay monthly fees that cover most of the medical expenses they may or may not incur during the month. Often, they are also required to pay a co-payment (also referred to as a co-pay). A co-payment is an amount paid at the time of treatment to offset a portion of the medical costs. The amount of the co-pay varies depending on the specific medical treatment. Medical office visits have a different co-payment rate than prescriptions and more involved medical treatments. Health Maintenance Organization plans also require members to select a physician as there primary care physician (PCP). This physician is the member's primary care giver regarding all health-related issues and must refer them to other physicians if a specialist is needed. Members cannot go directly to a specialist on their own accord. Not all managed care providers have this requirement.