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May 19, 2006, Newsletter Issue #29: Health Maintenance Organizations (HMOs)
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Tip of the Week
Looking for tips on HMOs & PPOs and the difference between them?
HMO stands for health maintenance organization. In exchange for paying premiums, the Health Maintenance Organization (HMO) agrees to cover both your routine and emergent health care expenses. These expenses might include routine office visits, prescriptions, surgical procedures, laboratory tests, inpatient stays, as well as other services. HMOs are considered a type of managed care health insurance plan.
This means that in exchange for generally lower premiums, deductibles, and co-pays, you agree to seek services only from doctors and pharmacies that belong to the insurer's network of pre-approved providers. If you receive care outside of the network, you may have to pay for some or all of the costs out of your own pocket. Exceptions are generally allowed for emergency care.
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