Pros And Cons Of HMO Health Plans
HMO Health Plans

HMO health plans (Health Maintenance Organization) allow the insured to pay a monthly fee in exchange for basic health care benefits. No HMO plan is completely comprehensive, and many plans will vary in what services are provided.

HMO health plans recommend a network of physicians you can use for your needs. Within this list, you choose a primary care physician who evaluates you and may make a referral to specialists (within the network) if he or she feels there is a need.

Pros And Cons Of HMOs

HMO health plans have some advantages. When under an HMO, you are not required to have a claim form for hospital stays or doctor visits. HMOs are often times more affordable than other plans, and offer you a fixed monthly premium. If you follow the rules, then using an HMO plan is possibly the least complicated form of health insurance coverage, and is generally less costly than other health insurance plans, like PPOs.

However, HMO health plans are not always popular. Your choices of doctors and hospitals is very limited, and must be on the network of physicians approved by the insurance company.

Because the physicians are under contract with the insurance company, stringent rules apply. Even if you want to see a specialist within the network, you will need a referral from your primary care physician.

The Deciding Factor

It should be noted though, that some HMO health plans do allow you to travel outside the network, but only in emergency situations. These relate to technicalities that have to be overturned for the wellbeing of the patient; not because of a patient's request.

HMO health plans offer benefits to patients who are not adventurous when it comes to choosing their own kind of health care. If you have had many years of experience and problems in dealing with health insurance providers, have your own favorite physicians, or require a level of flexibility, then HMO health plans will not offer much for you. But if physician selection is of little important to you, and you just want reliable coverage with low monthly premiums, then it may be just the plan you're looking for.