Health Maintenance Organization — HMO Plans, Coverage, and Quotes
A health maintenance organization, otherwise known as an HMO plan, is the most comprehensive type of short term health insurance available. In exchange for paying a monthly premium, HMO health plans cover the cost of most routine health care expenses. Out-of-pocket costs of HMO insurance plans are mostly co-payments for prescription medications and doctor visits, which have to be paid at the time of service. The cost of temporary HMO health insurance plans usually doesn’t vary with the amount of services used.
To use an HMO insurance plan, you must first select a primary care physician (PCP). This doctor has to refer you to medical specialists in order for a specialist to be covered by your HMO health insurance plan. Moreover, your primary care and specialist physicians must be members of your HMO plan network. This can limit your options, so it is always important to examine the provider networks of several short term HMO health insurance companies. This way, you can find out if any specialist doctors you may need are within the network.
Short term health insurance quotes are often more expensive if you choose to go with an HMO health plan. Despite that, you will have to pay little or nothing in deductibles. Don’t forget that going outside of the individual HMO plans’ network can be very expensive. You will have to pay the entire cost of out-of-network non-emergency medical care by yourself. An HMO plan heavily subsidizes health care costs through fixed monthly fees and other incentives for doctors to absorb costs; as a result, physicians often charge HMO health insurance plans less. While seeing a primary care physician in-network may cost a $10 to $40 co-payment, the full rate for going outside of the network could be several hundred dollars.
Short term health insurance plans allow you to take advantage of preventative care services. A typical HMO plan covers screenings and treatments that you may avoid if you are uninsured. Patients with HMO health plans are likely to have illnesses that are caught earlier, before they turn serious. For example, cancer can be discovered in its earliest stages, when it is easier and less expensive to treat. In the long run, this can lead to better health and lower health insurance costs. In addition, HMO plans are more convenient than other kinds of health insurance. You do not have to file a claim in order to get your HMO health insurance plan to cover hospital stays or doctor visits within the network. This breadth of coverage and ease of use means that cheap short term health insurance is somewhat rare in an HMO health insurance form, although there are plans available.
The HMO health plan can be a good value if you are satisfied with the doctors it covers, although this form of short term health insurance coverage may be difficult to find. Networks vary between HMO insurance plans, so you should find out if your current primary care physician and/or specialists are included before choosing an HMO plan. Some doctors work exclusively with one network, but others are independent and contract with multiple HMO networks. In addition, there are certain in-network hospitals, labs, and express care/urgent care clinics you may need to use in order to incur the lowest out-of-pocket expense.
What if you don’t have a primary care physician at all? There are several factors to consider when selecting a short term health insurance plan. First, you need to ask if the HMO plan covers your geographic area. What help is an HMO with inconvenient, far-flung physicians? It is recommended that you select an individual HMO plan that includes providers no more than 30 miles from your office or home. Also, the average wait time to see any new physician for routine care should be determined. Remember that you must be comfortable with the PCP you choose, as this person will largely serve as the “gate keeper” to your health care.
VitalOne can help you decide if a short term HMO health insurance plan is right for you. Our licensed health insurance agents will provide you with several affordable temporary health insurance options.
