With an HMO Health Plan, you choose a Family Doctor from your HMO’s Provider Network. The Doctor you choose becomes your Primary Care Physician and is responsible for ALL of your Health Care. You cannot see a specialist without a referral from you Primary Care Physician. If you see another Doctor without a referral, your HMO will not pay for your care.
Cost is the main benefit of an HMO Health Plan. HMOs are one of the cheapest forms of health insurance because they usually are large organizations that can buy services for thousands of people at reduced costs. Moreover, people with an HMO Health Plan only have to pay a small Copayment for Doctor or Hospital visits. HMO’s are also much easier to administer, as you really don’t have to do anything besides go to the correct Doctor.
It works great if you stay inside the plan. Great coverage at a lower cost. But, there is no coverage outside of the Plan. Parents prefer HMO’s, as kids often have to go to the Doctor so often.