Why Switching To An HMO Plan Could Save You Money On Your Healthcare Costs

Health Maintenance Organizations arrange or provide managed care for health insurance. Employers are required to offer federal certified HMO options if they have 25 employees or more when they also offer traditional healthcare options.

How it works

HMOs are regulated at state and federal levels and only cover care by medical professionals who have agreed to treat patients within their guidelines and restrictions, although they provide emergency care regardless.

Generally they will require you to choose a primary care provider to coordinate all of your care, including any specialists you need to see.

Benefits

This can take the work out of trying to find a specialist yourself and because all your care is coordinated through a Primary Care Physician (PCP), the costs of the plan are usually lower. Treatment doesn’t have to be pre-authorized by the insurer so you can get tests, treatment and procedures faster.

Disadvantages

There is less freedom of choice of providers, as smaller networks are used to reduce costs. You won’t be able to use a provider who does not belong to the network and in addition your PCP may not agree to all the procedures that you want. You therefore need to have a high degree of trust in them. In addition you will have to pay copayment fees for every medical visit. If you prefer to chose your own provider and specialists than an HMO arrangement may not meet your needs.

Research

It’s important to research the ratings for various HMOs and also check the details – for example that the nearest network approved emergency room is close enough to you.