HMO (health maintenance organization)
Out of the four categories of health insurance, HMO plans are the least expensive option. The downside to the lowered cost is restricted access to health care. Plans have a set monthly fee, covering doctors within the plan. If you visit a doctor outside of the plan, you are then responsible for the bill. Within a given plan, you are responsible for choosing a Primary Care Physician (PCP) who will coordinate your care. This includes:
- Routine and preventive care.
- Referrals to a network specialist or facility when necessary.
- Treatment for injuries and illness.
With some plans, you may need to pay a coinsurance, however with other HMO plans, there is no fee for doctor visits.