What is an HMO?

A health maintenance organization, or an HMO, is a common type of health insurance plan.

If you’re a member of an HMO, your insurance company agrees to pay for your health care when you use a specific network of doctors, hospitals, and health care providers. Many HMOs are budget-friendly and focus on wellness, prevention, and integrated care.

HMO Basics
With an HMO, which is a type of managed care organization, you use a network of doctors, hospitals, and other health care providers that your insurance company has pre-approved for services and payment. They’re called in-network providers.

Your HMO makes agreements with these providers. The HMO chooses how much it’s willing to pay for different services. The in-network providers agree to accept these fees for their services.

With an HMO, you choose a primary care doctor who’s in-network to coordinate your care. You must get a referral from your primary care provider in order to see a specialist.