HMOs are managed care plans that provide care for enrollees by contracting with specific health insurance plans care providers to provide specified benefits. Many HMOs require enrollees to see a primary care physician (PCP) chosen by the member who will refer them to a specialist if deemed necessary.
HMO plans often do not include deductibles, but copays are charged per office. HMO plans typically allow a member to have lower out-of-pocket healthcare costs, but require the member to forego some choice and flexibility with regard to selecting physicians and hospitals.
Additionally, HMOs do not cover non-emergent services received from providers outside the network. HMOs do not require members to submit claims to the insurance carrier.
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