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HMO
(Health Maintenance Organization)
An HMO is a health insurance plan that provides care through a network of designated providers, typically requiring members to select a primary care physician (PCP) who coordinates all care and provides referrals to specialists.
HMOs emphasize preventive care and generally have lower premiums (about 15% less than PPO plans) and predictable copays rather than coinsurance. However, they restrict coverage to in-network providers except for emergencies. About 30% of employer-sponsored plans are HMOs. While cost-effective, HMOs require more care coordination and offer less flexibility than PPOs, making them better suited for those willing to trade choice for lower costs.
HMOs emphasize preventive care and generally have lower premiums (about 15% less than PPO plans) and predictable copays rather than coinsurance. However, they restrict coverage to in-network providers except for emergencies. About 30% of employer-sponsored plans are HMOs. While cost-effective, HMOs require more care coordination and offer less flexibility than PPOs, making them better suited for those willing to trade choice for lower costs.