A health maintenance organization (HMO) is a type of health insurance plan that delivers its medical benefits within a restrictive provider network model where out-of-network care is not covered by the insurance (except in the case of limited emergency conditions). People who are enrolled in an HMO must select a primary care physician (PCP) and this PCP must be consulted to obtain referrals to other providers within the HMO network.
HMO networks tend to have fewer heath care providers than PPO networks. The HMO’s more limited network gives the plan greater financial leverage over participating providers and may result in lower insurance premiums.
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