Health Maintenance
Organizations
A type of managed-care organization, an HMO provides health care
through contracted hospitals, doctors and providers. One objective
of an HMO is to reduce the cost of health care through strict
management.
The HMO requires you to make a co-payment to an in-network
physician and will not pay for services you receive outside the
network. If you have an HMO, you must choose a primary care
physician (PCP), who, in essence, is the gatekeeper to all other
medical care. To see a specialist, your PCP has to authorize it and
refer you.
Under an HMO, preventative care like well-child care and
mammograms is discounted or free to encourage individuals to stay
healthy.
You May Want an HMO If:
- You are a relatively healthy individual with no abnormal
conditions that would require a specialist
- You want to avoid filling out numerous insurance forms
- You value preventative health care in the form of programs
that encourage healthier life choices to achieve better health
- You'd like to benefit from slightly reduced premiums
- You don't mind working with only one primary-care physician
who must refer you to a specialist for any unusual medical needs
Evaluate your health, financial situation and time
constraints-even your personality type. If you are the type who
prefers structure and organization, an HMO would suit you best.
Weigh the options, talk to friends and family about the
types of plans they have, and choose what you think will work best
for you!
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