Monday, September 06, 2010
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Health Maintenance Organizations (or HMOs)

Florida has the fourth largest number of Health Maintenance Organizations (or HMOs) in the country. Such a popular option must have offer important benefits.

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Advantages of Health Maintenance Organizations (HMOs)

  • It is usually the lowest cost to you (the customer) for the widest range of healthcare services.
  • An HMO often covers preventive care, such as regular check-ups and health screenings.
  • It requires very little or no paperwork, such as filing claim forms or keeping medical receipts.

 

Limitations of HMO Plans

  • You receive all of your health care from the HMO’s exclusive network of providers. If you choose to go to a doctor outside of the network, for example, none of your costs will be covered.
  • You choose a primary care physician from within the network.
  • This primary care physician acts as the “gatekeeper” for specialty care. If you need to see a dermatologist or cardiologist, for example, you must first receive a referral from your primary care physician.

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Health Maintenance Organization (HMO) Product Features

As with other types of insurance, you pay a monthly premium (fee) in order to receive coverage under an HMO. As mentioned above, this premium is usually less than you would pay for the same services under another type of plan. This is because under “managed care” plans, like HMOs, the company can control (“manage”) its costs by providing all healthcare through its network of doctors.

Also, like other types of insurance, some HMOs have a co-payment. This means that you may pay a set amount (generally $10 or $25) for each doctor’s visit or prescription. Some HMOs now offer plans with deductibles, in order to further lower your monthly premium.

HMOs are not for everyone. Some prefer the greater freedom in selecting doctors and other healthcare providers that traditional insurance plans offer. But if you are looking for the widest range of services at the best price, if preventive care is important to you, and if you’d rather not deal with paperwork - an HMO plan may be right for you.

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Florida-Health-Plans is not an insurer and cannot issue health insurance policies. This site provides free information on insurance services and coverage options. Products and services may not be available in all states, and no guarantees of the same are made herein.
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