HMO Plans & Options

It is pretty common for Health Maintenance Organizations (or HMOs) to receive bad press, complaints, and an overall negative reputation.  Some common things that are said include the notion that these types of medical care plans are difficult to use, too slow-moving to be effective, bogged down by paperwork and bureaucracy, and otherwise ineffective at living up to the “maintenance” aspect of their name.  However, while these policies are not the best, nor the most flexible, they are usually exceptionally affordable and good ones are certainly available for people who need to they can offer.

Let's take a deeper look at the pros and cons of HMOs.

On the plus side, health insurance is incredibly expensive, and saving money however you can is increasingly important in an unstable global economy.  This type of coverage can be more affordable than others, allowing individuals and families who need medical care to have a way to access it without facing financial ruin the way uninsured people can.  Health insurance is a necessity, and even an imperfect policy is better than nothing.

HMOs are also good for providing basic well-care to make sure that people stay healthy and avoid the catastrophic illnesses and injuries that can be both costly and devastating.  You will also be required to choose a primary care provider.  Since this physician is the one with whom you will have the most contact over the course of your policy, you should be able to build a relationship with him or her over time – a relationship that can be very beneficial to your own wellness.

Of course, there are definite negatives to a policy like this.  For one thing, the reason these types of programs can offer such great rates is because they contract with a very small number of doctors and specialists.  They end up sending a large volume of patients, which in turn, results in to drastically discounted pricing for the insurance company.  For patients, however, this means a limited choice in care providers; not so bad if you don't already have a favorite doctor, but potentially difficult if you have a personality conflict or other issue with the person who ends up being your PCP. 

These organizations are also able to provide the rates they do because they require subscribers to get referrals if they wish to see a specialist.  This allows the primary doctor to approve or veto requests based on his or her own knowledge of the situation, resulting in a smaller number of patients going to specialists and thus, lower costs for the company.  Not everyone is willing to give up the right to see any doctor they choose, at any time, and so many people turn to PPO plans to ensure that they have a wider range of options.

Ultimately, many people end up choosing HMOs simply because they are affordable.  However, we are happy to help you evaluate all of your choices, as well as the possible risks and benefits before you make such an important decision.  Get a free quote today!