HMO, or health maintenance organization, is a type of health insurance plan that (usually) restricts you from receiving the care of doctors who do not work under contract with the HMO. Partnered with specific doctors, your HMO will want you to use their vetted providers.
While it does seem odd that such a restrictive plan would be popular cost is the main reason people consider HMOs apart from other types of healthcare coverage we will dive into later. When it comes to cost, a HMO has lower monthly premiums than other types of insurance plans and tends to have lower copays. It’s a much more affordable option for people who don’t often need anything more than basic medical care like annual checkups and vaccinations. If you are generally in good health and just want to make sure you’re covered – this would be the perfect type of plan for you.
Much like having a regular customer at the club, an HMO requires you to pick a primary care physician (PCP) who will be the sole doctor you go to for everything you need. In the event you need a specialist it will be your PCP who recommends said specialist, also in your HMO’s network. You know those insanely slow nights where you look around at an empty club while you, luckily, have your loyal regular there to get you thru it. That loyal customer and the rapport that builds on itself each time they come in. Your PCP has a better chance for painting the most accurate picture of your health and building a relationship with you this way – or at least that’s the thought process behind these types of plans.
Remember that health insurance is not a one size fits all situation and to make sure you are asking questions that best fit your specific needs. Never be afraid to ask questions or for examples. Some people may greatly benefit from an HMO while others may like the freedom of a PPO more. It is ultimately up to you what fits your lifestyle best!
