What is a Health Maintenance Organization (HMO)?

A Health Maintenance Organization (HMO) is a network of hospitals, doctors, and other healthcare providers that agree to coordinate care within a smaller, local network in return for a certain payment rate for their services.

An HMO generally only covers care received from the plan's contracted providers, known as "in-network" providers. When members are covered through an HMO, they may need to select a primary care doctor (PCP) to manage their health care and refer them to specialists within the network. However, in a medical emergency, members may seek emergency care from the closest emergency room.

An HMO plan might be right for you if you are looking for lower costs and you don't mind choosing your doctors from within the HMO's network. Overall, think lower cost with less flexibility to choose health care providers.

• Lower Premiums
• Low or no deductible (depending on metal level selected)

• Usually required to select a Primary Care Physician (PCP)
• PCP referral typically required for care from a specialist
• No non-emergency coverage outside of network