Health maintenance organizations (HMOs)

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Health maintenance organizations (HMOs) A health maintenance organization (HMO) is a network or organization that provides health insurance coverage for a monthly or annual fee. An HMO is made up of a group of medical insurance providers that limit coverage to medical care provided through doctors and other providers who are under contract with the HMO. The purpose of a Health Maintenance Organization is to focus on overall patient wellness and preventive healthcare while keeping costs low for its members by only covering in-network physicians and facilities. There are four basic models of HMOs: group model, individual practice association (IPA), network model, and staff model. This plan usually limits coverage to care from doctors who work for or contract with the HMO. It generally will not cover out-of-network care except in an emergency. An HMO may require you to live or work in its service area to be eligible for coverage. An HMO contracts allow for premiums to be lower since the healthcare providers have the advantage of having patients directed to them but they also add additional restrictions to HMO members. HMO plans require that participants first receive medical care services from an assigned provider known as the primary care physician (PCP). #benewinsurance #insurtech #inclusiveinsurance #insurance #reinsurance #takaful

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