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Health Maintenance Organization Plans (HMO Plans)

Health insurance is something we all need at every stage of our lives. Not having adequate coverage or insurance at all makes you and your family more susceptible to unexpected medical cost. Health insurance allows you and your family to affordably get medical care whenever any health scares arise. When choosing an insurance carrier or plan, you want to a make sure that you review all the options available. Of the many choices for health coverage for individuals and families, one of the most popular is a Health Maintenance Organization Plan (more commonly known as an HMO).

HMO Plans put a great emphasis on maintaining a healthy lifestyle by encouraging regular doctor visits which lowers the cost for insurance providers. The Health Maintenance Organization Plans are able to offer many medical services through a wide network of doctor’s offices, hospitals, and other providers. By opting for an HMO plan, you will have access to a wide range of both preventative care and coverage. These plans cover sickness, injury, or other emergencies. Like most health insurance plans, HMOs focus on regular preventative health practices like annual checkups, immunizations, and medications.

From within the large network of medical providers, you will be able to choose a Primary Care Physician (PCP) who will be your year round physician whenever you need medical attention. Whether it is just a checkup or if you need to go to your doctor with a concern, your PCP is the place to start. With HMO Plans your physician will either treat you themselves or refer you to another specialist within the HMO network whenever possible. This is may be one of the least appealing benefits to HMO network as that you cannot be seen by a specialist without a referral first.

You will generally have predetermined co-pays, which must be paid to the office on the day of your visit. In most cases, the co-pay will be the same. The co-pay change depending on the specialist you see. Typically the person booking the appointment will let you know if there are any additional charges. The HMO acts as a go-between with you, your doctors, and the insurance claims department, saving you time and frustration. Health Maintenance Organization Plans are a good choice if you are looking to have lower out-of-pocket expenses in addition to hundreds of doctors. These plans tend to have relatively low premiums and co-pays but can restrict choice when it comes to selecting a doctor or hospital.

HMO Plans are popular in the US among both individuals and employers providing health benefits to their staff. Because of the relatively lower out-of-pocket costs and streamlined co-pay system for doctors and prescription drugs, Health Maintenance Organization Plans keep overhead low for the subscriber. What they lack in for instance variety or options, these plans make up for in savings. Their focus on preventative and necessary care means that unnecessary or unusual tests and procedures are unlikely to be covered. Built from a network of medical providers, HMOs do a lot of the footwork in advance so you will not have to.

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