Health Maintenance Organization or HMOs are the oldest form of managed health care and are typically the least expensive way to get medical care. HMOs offer a wide range of benefits, including preventive care, for a set monthly fee. HMO plans generally do not have deductibles, rather, you make a co-payment for the services performed. For example, when you visit a doctor’s office it may cost $20. However, if you need to be seen by a specialist HMO plans require you to get a referral from your Primary Care Physician before you can receive any treatment. Your Primary Care Physician must also belong to a specified medical group classified by the HMO.
You do initially choose a primary care physician from a list of participating doctors from the health maintenance organization. If you need to need to be hospitalized, see a specialist, or have lab or X-ray work; your doctor will refer you to a provider or facility that is also on the HMO network. Your primary doctor must give authorization for those services to be covered by your HMO. You also might have to pay a portion of the cost yourself, called a co-payment, for each office or hospital visit, such as $15 per doctor visit, regardless of what the services cost. Some services such as; mental health, emergency room, and chemical dependency services, may also require extra fees.
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