Updated March 21, 2013.
Definition:
If you are enrolled in a health maintenance organization (HMO) you will need to receive most or all of your health care from a network provider. HMOs require that you choose a primary care physician (most often an internist, family doctor, or pediatrician for your children) who is responsible for managing and coordinating all of your health care.
If you need care from a physician specialist in the network or a diagnostic service such as a lab test or x-ray, your primary care physician (PCP) will have to provide you with a referral.
If you do not have a referral or you choose to go to a doctor outside of your health plan’s network, you will most likely have to pay all or most of the cost for that care.
HMOs usually have small copayments for doctor visits and prescription drugs and no claims to file.
Also Known As: HMO
Definition:
If you are enrolled in a health maintenance organization (HMO) you will need to receive most or all of your health care from a network provider. HMOs require that you choose a primary care physician (most often an internist, family doctor, or pediatrician for your children) who is responsible for managing and coordinating all of your health care.
If you need care from a physician specialist in the network or a diagnostic service such as a lab test or x-ray, your primary care physician (PCP) will have to provide you with a referral.
If you do not have a referral or you choose to go to a doctor outside of your health plan’s network, you will most likely have to pay all or most of the cost for that care.
HMOs usually have small copayments for doctor visits and prescription drugs and no claims to file.
Also Known As: HMO
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