Health Maintenance Organization

Insurance

A Health Maintenance Organization (HMO) is a managed-care health plan that requires you to use in-network providers and get referrals from a primary care physician (PCP) for specialist care. HMOs typically have lower premiums, lower deductibles, and lower out-of-pocket costs than PPOs — at the cost of less flexibility. Out-of-network care is typically not covered except in emergencies. Good for: healthy individuals or families willing to coordinate care through one PCP. Bad for: people with established specialist relationships, frequent travelers, or those wanting maximum choice. The premium savings can be substantial; verify your preferred doctors are in-network before enrolling.