HMO's (Health Maintenance Organizations):
An HMO
is a private corporation that contracts with physicians, hospitals,
employers and individuals to provide health insurance coverage in exchange
for a fixed fee, or premium. Individuals must choose a primary care
physician within the HMO network, through which all the healthcare decisions
will be made (medication, hospitalization, tests and referrals to specialists).
!
Many employers
offer their employees a health care plan through an HMO.
HMO
Advantages:
- very
few out-of-pocket costs
- prescription
and other "extras" are often covered
HMO
Limitations:
- this
type of plan will allow you to see only doctors that belong to that
HMO's network of providers.
- you
are limited in your choice of hospitals - if a hospital is not part
of the HMO network, you will have to bear the full cost if you are
admitted there.
- HMO
physicians are often limited in the type of care they prescribe due
to HMO's emphasis on cost-cutting. Many patients have filed lawsuits
accusing certain HMO's of short-changing patient care in the name
of cost containment. Research your employer's plan carefully.
