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HMO Plan
Typical HMO (Health Maintenance Organization) Plan
Only covered expenses are considered eligible for payment. Know your policy’s limitations and exclusions.
HMOs typically cover preventative care as well as medically necessary expenses.
Requires selection of a PCP (Primary Care Physician) to whom you must go for all care and all referrals to specialists.

May or may not include all laboratory, x-ray, and surgery charges associated with the doctor visit.
Allows you to go to the doctor by paying a small co-payment.
Unlimited
Lifetime Maximum


HMO
pays at
100% rate
after the Out-
Of-Pocket
limit is
reached

 

 
$100 co-pay
$50
co-pay
$10
co-pay
20% co-pay
$10
co-pay
$50
co-pay
You MUST use HMO Member Providers for all your medical care.
NO coverage is provided for care received from non-member providers, except in emergency situations.
You are 100% liable for non-emergency non-member charges.


 


Each service or procedure has a co-payment that you pay. When the total of all your co-payments equals the out-of-pocket limit, the HMO pays 100% of charges.
Primary Care Doctor Visit
HMO Policy
  

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