A health maintenance organization (HMO) is a network or organization that provides health insurance for a monthly or annual fee.
HMO is made up of a group of health insurance companies that limit coverage to health care provided by doctors and other providers under contract to the HMO.
These contracts allow premiums to be lowered because health care providers have the advantage of referring patients to them, but they also place additional restrictions on HMO members.
HMO plans require members to first get health care services from a designated provider, known as a Primary Care Physician (PCP).
Preferred provider (PPO) plans and point-of-care (POS) plans are two types of health plans that are alternatives to HMOs.
If you have an HMO plan, you should always contact your PCP first, who will then refer you to a network specialist. With a PPO plan, you can see a specialist without a referral.
If you have an HMO plan, you must stay in the provider network to get coverage. Patients still have a network of providers under the PPO plan, but they are not limited to seeing these doctors.
The Consolidated Comprehensive Budget Reconciliation Act (COBRA) allows many employees to remain in their employers’ group health plans for a specified period of time after losing their job.
HIPAA affects policy, technology, and record keeping in healthcare facilities, health insurance companies, health insurance companies, and health care billing services.
A Health Savings Account (HSA) is a tax-advantage account that helps people save on medical expenses that are not covered by high deductible health insurance plans.
Long-term care insurance typically covers all or part of nursing facilities and home care for people aged 65 or older or with a chronic condition requiring ongoing care.
“This is private insurance available to anyone who can afford to pay for it.