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HMO Health Insurance
Looking for Group Health Insurance?
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. 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. Compare to PPO Health Insurance
HMO Terms to Familiarize Yourself with:
Co-payment.
A type of cost sharing where insured persons pay a specified fee for service or a percent of the amount allowed as reimbursement for a covered service. Also referred to as "co-insurance".
Deductible.
An amount the insured person must pay before insurance payments for covered services begin. There may also be other, separate deductibles that apply to certain types of services.
Exclusions.
Conditions, situations, and services not covered by the health care plan.
Health Care Provider.
A doctor, hospital, laboratory, nurse, or anyone who delivers medical or health-related care.
Pre-existing Conditions.
A condition for which medical advice, diagnosis, care or treatment, including use of prescription drugs, was recommended or received from a licensed health practitioner during a specified period of time immediately preceding the effective date of coverage.
Primary Care Physician
The doctor in your HMO network who coordinate the member's medical care. Your primary care physician provides you with routine medical care and will refer you to a specialist when necessary.
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. 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. Compare to PPO Health Insurance
HMO Terms to Familiarize Yourself with:
Co-payment.
A type of cost sharing where insured persons pay a specified fee for service or a percent of the amount allowed as reimbursement for a covered service. Also referred to as "co-insurance".
Deductible.
An amount the insured person must pay before insurance payments for covered services begin. There may also be other, separate deductibles that apply to certain types of services.
Exclusions.
Conditions, situations, and services not covered by the health care plan.
Health Care Provider.
A doctor, hospital, laboratory, nurse, or anyone who delivers medical or health-related care.
Pre-existing Conditions.
A condition for which medical advice, diagnosis, care or treatment, including use of prescription drugs, was recommended or received from a licensed health practitioner during a specified period of time immediately preceding the effective date of coverage.
Primary Care Physician
The doctor in your HMO network who coordinate the member's medical care. Your primary care physician provides you with routine medical care and will refer you to a specialist when necessary.
