HMO Health Insurance


An HMO health insurance plan is a Health Maintenance Organization and is one of the more popular options that is on the market and utilized by many that believe health insurance is out of their reach. The HMO will have a certain doctor, hospital and specialist that they assign people to depending on the area in which they live. The health insurance is going to pay for all types of well visits in order to encourage the person to avoid becoming sick through well checkups. With that being said, there are many people that are not big fans of the HMO health insurance simply because they may have to travel long distances in order to get to a provider that is a part of the organization. If the person were to go to a provider that is not included, the health insurance is not going to pay for anything, so it would be the same as if the person had no health insurance at all.

 In order to use the HMO health insurance, the person will sign up for this and then once they have been processed and are now a member of the insurance plan, they will receive information as to who they can see. They can pick the provider that they see based on their preferences such as gender, location and distance from their home. However, most companies are going to include a provider that is within so many miles of the home address that they believe is the best fit for the person. When the person goes to see the doctor, they will find that they are paying a small co pay, usually around ten or twenty dollars. The reason for the low cost is that the health care providers that are a part of the organization work with the health insurance company to keep the costs of the procedures and tests ran to a minimum.

 The HMO health insurance plan will cover the costs associated with the doctor visit, any tests that are mandatory and ordered by the doctor, prescription drugs as long as they are the generic brand and any other costs that the doctor has put in as part of the patients care. This is very important to remember as the health insurance will in most cases, not pay for a procedure that is optional or is for purely cosmetic purposes. The whole idea behind this insurance is to maintain the well being of the person and not to provide compensation for anything that is not deemed medically necessary. It is also important to note that when the person wants to see a specialist, this will only be paid for if the primary care doctor puts in a referral for this, and then the referral must be approved by the health insurance company in order to be paid for. If the person simply wants a second opinion, in most cases, they will find that they have to pay for the total cost of this on their own.

 The good news about the HMO is that the person will pay no deductible before their health insurance kicks in. They will have immediate health insurance to use and will go on paying their co pay for the rest of the physical year. Since there are no percentages that the health insurance will pay, as they pay everything but the co pay most people like having the HMO insurance. However, in order to make this work for them, they must always see a health care provider that is included with the organization. And from year to year these doctors change, thus before going to the doctor; they should make sure that they are a part of the organization.