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HMO Plans Offer a Network of Providers


HMO stands for Health Maintenance Organization. With an HMO plan, you must choose a Primary Care Physician (PCP) from a network of local healthcare providers who will refer you to in-network specialists or hospitals when necessary. All your care is coordinated through that PCP.

Is an HMO plan right for you?

With an HMO plan, your out-of-pocket medical costs and monthly premiums will generally be lower than with other types of plans. If you are someone who doesn’t see a lot of specialists or would like having your care coordinated through a PCP, then you might save more money with an HMO plan. When you apply for an HMO plan, you’ll select a Primary Care Physician who will be the first point of contact for your healthcare. Your PCP will be able to see the total picture of your overall health. Together you can make the best decisions to manage your health and well-being, which includes your PCP making referrals to specialists. If you have a standing relationship with a doctor or specialist outside of your network, or would prefer more flexibility when choosing your care providers, you might consider a Preferred Provider Organization (PPO) plan instead. PPO plans often feature a higher monthly premium and out-of-pocket medical costs but will allow you the freedom to choose doctors and specialists that are in- or out-of-network without a referral from a PCP.