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What is an HMO?

A Health Maintenance Organization (HMO) is a private company that provides medical care from an approved network of doctors, hospitals, and pharmacies. With an HMO, a patient needs to pay a set minimum fee per visit to a care provider. These fees are usually much lower than with a PPO (Preferred Provider Organizations) plan. The advantages of HMOs is that they usually have very low deductibles or none at all. They also have very comprehensive benefits, while emphasizing preventative care. The disadvantages of HMO are that they only use a particular chain of hospitals and doctors, and the patient must see doctors within this network. If the patient wishes to see a specialist they must first retrieve a referral from the primary physician, or the HMO may not pay for the services. Additionally, HMOs often refuse to pay for emergency visits if they do not consider it to be a true emergency.


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