What is a health maintenance organization (HMO)?

A health maintenance organization (HMO) is a type of health insurance plan that is available to residents of Hawaii. An HMO provides a person with comprehensive health coverage through a specific network of health care providers and facilities. This can include both primary and specialty care doctors as well as hospitals, labs, and other health care facilities. The benefit of an HMO is that it can provide access to a wide range of medical services for a lower monthly premium than other types of health insurance. An HMO usually requires both a primary care physician and a referral to a specialist in order to access care. The primary care physician is responsible for coordinating and providing most of the patient’s care, including preventive care and diagnosing and treating health issues. If more specialized care is required, the primary care physician must refer the patient to a specialist. In an HMO plan, coverage does not typically extend to services obtained outside of the network of care providers. This means that out-of-network care, such as for emergency services or specialists not identified in the HMO’s network of providers, are typically not covered and can be costly. It is important to understand the details of the plan before enrolling in an HMO.

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What is a health maintenance organization (HMO)?

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