Arizona HMO Plans
The Health Maintenance Organization (HMO) plan is the most commonly-used and well known of the health insurance plans available. HMO is a fairly broad term, and refers to any organized healthcare plan that is not sold by a traditional health insurance company.
HMO plans are prepaid, meaning that you’ll pay a monthly premium just as you would for any other type of health insurance. In return, you are covered for all medical costs, as long as you visit doctors and specialists that are recommended by the HMO. In most cases you’ll be able to choose your primary care doctor from a list provided by the HMO.
Your Primary Care Doctor in Arizona and HMO Plans
Your primary care doctor is essentially just like a family doctor. You can visit them as often as is required, and they’ll refer you to a specialist in the HMO network for health issues that require specialist care. You can choose to visit a doctor or specialist who is not part of the HMO network of recommended practitioners, but the costs of those visits are not covered by your health insurance.
Under a typical HMO plan, you can expect to be covered for some or all of the following services:
- Visits to your primary care doctor and any specialist they refer you to
- Diagnostic laboratory services
- Hospital services (including diagnostic procedures that require a hospital visit)
- Emergency services (some plans provide coverage for emergency services even if you do not use a network healthcare provider)
- Pharmacy services (prescriptions)
The average HMO plan will not cover you for unconventional treatments such as acupuncture, for elective cosmetic surgery, or for routine dental work. The list of treatments that isn’t covered is often different for each HMO, so if you already have an HMO plan it’s best to check your specific plan and find out exactly what you’re covered for.
Most HMO plans are available only to employer groups, and rarely accept individuals or families as members if they are not part of such a group. Choosing an HMO plan is a good option for any individual or family who does not have special medical needs that aren’t covered by the plan. The main advantage of these plans is that they are typically less expensive than purchasing health insurance from a traditional provider, as HMOs can provide healthcare at lower cost to the consumer because they deal with a much larger volume of business.
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