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Health Insurance HMO

The term HMO stands for health maintenance organization. This is a type of managed care organization that helps to provide health insurance coverage to people within the United States. If your health insurance falls under the term HMO, it's important to be aware of the different terms and statues applicable to you. Different doctors, hospitals, clinics, and specialists have a contract with various HMOs. Not all hospitals and doctors do, however, so it's vital to know which ones fall under your health insurance HMO plan. If not all doctors or hospitals participate in this plan, why do some choose to be a part of an HMO plan? The reason is simple: HMO plans help to guarantee private practices, doctors, and hospitals will have a constant flow of patients, which brings in business. In return, the doctors agree to provide their services at a discount. In return, the HMO provider can give patients a much lower premium than other health insurance plans, but the downside is that there are a lot more restrictions as far as what is covered, how much is covered, and where the patient can go to seek health care. A health insurance HMO plan provides customers and patients with a Primary Care Physician, or PCP. This PCP is the patient's main point of contact for almost all treatment. Usually the PCP will then refer the patient to specialists within the HMO network if needed. This helps to ensure that all transactions are done within the network so that everything is covered.

The most common roles of PCPs are internists, general practitioners, and OBGYN doctors. Emergency care is eliminated from following the guidelines set forth by the HMO so that in the event of an emergency, a patient can simply go to the nearest hospital and be treated and covered. Some health insurance HMO plans also allow women to choose whichever OBGYN doctor they like, even if they are not included in the network. Today, preventative medicine has been determined to be a vital part of maintaining the overall health and well being of the country. Because of this fact, the HMO laws have changed in recent years, now allowing immunizations, baby wellness check ups, mammograms, and physicals to be covered with either a copayment or even free of charge, depending on the circumstance. Health care providers have made it clear that by performing early detection and prevention methods, the need for more serious health care can be decreased dramatically. The HMO companies have realized this, and now provide these services under most plans. In the case of chronic diseases such as asthma or allergies, HMOs may assign patients a case manager to periodically check their status and follow their treatments. Things like plastic surgery or other elective surgeries are almost never covered by a health insurance HMO plan. While the idea of HMOs have been the source of debate for many years, a lot of people feel they are one of the best health insurance plans available today.

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