kaiser HMO 10 Plans
HMO Health Insurance Plans, An HMO gives you access to certain
doctors and hospitals within its network. A network is made up of providers
that have agreed to lower their rates for plan members and also meet quality
standards. But unlike PPO plans, care under an HMO plan is covered only if you
see a provider within that HMO’s network. There are few opportunities to see a
non-network provider. There are also typically more restrictions for coverage
than other plans, such as allowing only a certain number of visits, tests or
treatments.
Some other key points about HMOs:
- Some plans may require you to select a primary care physician (PCP), who will determine what treatment you need.
- With some plans, you may need a PCP referral to be covered when you see a specialist or have a special test done.
- If you opt to see a doctor outside of an HMO network, there is no coverage, meaning you will have to pay the entire cost of medical services.
- Premiums are generally lower for HMO plans, and there is usually no deductible or a low one.
An HMO, or Health Maintenance Organization, is a type of managed care health
insurance plan. HMOs typically offer lower costs, but you will have a more
restrictive provider network, and you will have to coordinate your medical
care through a primary care physician (PCP).
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