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Affordable Health Insurance With An Hmo

By: Elizabeth Newberry

Health maintenance organizations, also referred to as HMOs, are one of the most popular forms of obtaining affordable health insurance. However, before you purchase affordable health insurance with an HMO, there are a few questions you should ask yourself and the HMO.

1. What kinds of medical care are, and are not, covered? This is the most important information to find out before purchasing any kind of health insurance plan. There’s no point in purchasing a health insurance plan that doesn’t provide the coverage you need. That’s a waste of money and time.

2. What is the monthly premium? Herein starts the balancing act. Your decision of what’s affordable and what’s not may depend on the co-payment for which you’re responsible.

3. How much co-pay will I be responsible for? Co-payments with HMOs generally range from $5 to $35, and depend on the particular medical service you’re receiving.

4. Who are my choices for a primary care physician? HMOs require you to choose a primary care physician from a list of doctors in the HMO network. This is the doctor that you will see for regular check ups and any health care service that doesn’t require a specialist. If you need to see a specialist, your primary care physician will refer you. There may be a few doctors in the network you are familiar with, or there may be no doctors in the network you feel comfortable seeing. If you’re aware of the doctors in the HMO network, you can make a better choice regarding whether or not you choose that HMO.

5. What happens if I see an out-of-network doctor without the approved referral of my primary care physician? If you see an out-of-network doctor without the approved referral of your primary care physician, you may be responsible for the entire payment, or your HMO may allow you to backtrack and obtain a referral from your primary care physician.

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