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HMO Health Insurance

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.

Some HMO plans, including those offered by Medical Mutual, don’t require you to select a PCP or have a referral to see a specialist.

Address

60 E Rio Salado Pkwy
Suite 900
Tempe, Az 85281

(800) 762-0860

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