HMO Plans
An HMO (Health Maintenance Organization) plan provides a network of hospitals and doctors for their subscribers to select from. Each HMO plan includes urgent care and global emergency coverage 24/7 services.
HMO offers health insurance coverage for a monthly/annual fee while limiting subscribers’ coverage to medical care provided through a network of healthcare providers under the insurance provider’s contract. With an HMO plan, subscribers are likely to have a broader range of preventive services than they would through other types of insurance health plans.
The organization enters contracts with networks of health providers with clinical facilities, primary care physicians, and other healthcare specialists. The health professionals that enter into contracts with HMO plans are paid an agreed-upon fee to provide services to the plan subscribers.
After subscribing to an HMO plan, the subscribers will be required to select a primary care physician, as long as they are in the HMO’s network. As for the subscribers that don’t choose one for themselves, HMO will assign them one.
Subscribers may not be obligated to pay a deductible before their coverage begins, and their copayments will be minimal. It is also important to know that subscribers will likely not have coverage for the services they receive out-of-network.
An HMO (Health Maintenance Organization) is a fairly more restrictive form of health insurance because it limits which clinical facility or doctors it will pay through insurance. Anyone that chooses to go out of the network could get stuck paying the full cost of care.
Because the subscribers are limited, they usually pay less health insurance premiums for HMO than other health plans. Also, HMO offers lower-cost prescription medicines. It also allows subscribers to have one doctor who gets to know their healthcare needs and coordinates their care.
HMO health insurance plans were created to regulate costs while keeping subscribers healthy. HMOs are lower-cost insurance options because hospitals and doctors in the provider network agree to provide their services at a set affordable price. Moreover, most of the HMO insurance plan costs are monthly premiums, a set deductible, and copays.
The average HMO plan can have a monthly premium of about $230, which is less than the average monthly rate for other health plans. Those that receive care from an in-network provider may also pay for a copay each time they receive care. This can help HMO subscribers better manage their out-of-pocket costs rather than paying towards coinsurance or deductibles.
Want to know more about the HMO insurance plan and how it can help you? Contact us today. At Senior Insurance Sales, you’ll be working with health insurance experts who are dedicated to assisting seniors in finding the health plan that works for them.