What is a health maintenance organization (HMO)?

A health maintenance organization (HMO) is a type of health insurance plan governed by health insurance law in the state of Texas. HMOs are designed to provide comprehensive healthcare coverage to their members at a lower cost than other types of health insurance. In a HMO, members are typically required to select a primary care physician (PCP) to coordinate their care. Additionally, members must receive their healthcare services from the HMO’s network of providers and health care facilities in order to receive coverage. Depending on the plan, members may be required to obtain referrals for specialty care from their PCP and/or get prior authorization from the HMO before receiving care outside of the participating HMO network. With an HMO, members typically receive preventative care, such as check-ups, vaccinations, and screenings, at no extra cost. Additionally, HMOs cover other types of care like lab tests, medications, and hospitalization.

Related FAQs

What is a catastrophic health insurance plan?
How does health insurance cover prescription drugs?
How does health insurance work?
What is a preferred provider organization (PPO)?
What is a coinsurance rate?
How does my age affect my health insurance premium?
What is an employer shared responsibility payment?
What is an independent review organization?
What are the different types of health insurance deductibles?
What is a balance billing?

What is a health maintenance organization (HMO)?

Related FAQs

Related Blog Posts