HMO Health Insurance

By: EconomyWatch Content   Date: 17 February 2010

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Health maintenance organization (HMO) health insurance plans are a variant of managed healthcare wherein the insured needs to decide on a Primary Care Physicists (PCP). The PCP is the first point of contact for any medical emergency. Depending on the kind of conditions, PCP advises the appropriate medical assistance and thus avoids the circumvention that often hampers effective medical care.

Technically, the HMO health insurance is such an arrangement where a network of doctors, hospitals and pharmacists is chosen for medical assistance. They all offer discounted assistance and in the bargain, earn from a generated loyalty. Their objective is to make the entire process more effective so that redundant medical expenses such as repeated ineffective prescriptions are avoided and a faster preventive as well as curative medical assistance gets active.

HMO Health Insurance Work Process

Once a person decides to go ahead with an HMO plan, he/she picks a PCP from an available list of doctors and physicians. The physicians can range from general practice to pediatrics. In case of medical need, this PCP is contacted. Any outside network visits are to be referred by him/her  to be eligible for HMO coverage otherwise the entire expense is to be borne by the person.

A key feature of HMO plans is their low cost. The absence of deductibles for most medical conditions makes them the most appropriate plans for families.

Advantages of HMO health Insurance

HMO health insurance was aimed to assist people with lower income to get access to quality health care. Therefore, cost benefits are evident in the plan in the form of no or low deductibles, family coverage, lower premiums and discounted medical assistance.  Even the co-payments tend to be as small as $5 to $10.

Preventive care is also covered with HMO health insurance. For the same reason, routine check ups, prescriptions, lab tests, baby care and vision exams are all paid for.

Therefore, HMO health insurance is the right choice for people who have lower incomes and bigger families to take care of. However, the only flip side is that the coverage does not apply for the expenses resulting from visiting outside-network doctors without referrals.

 


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