Health Maintenance Organization (HMO)
Insurance Glossary
A health plan that covers care only inside its network and usually requires members to name a primary care physician. A referral from that physician is typically needed before seeing a specialist, and care from outside the network is generally not covered except in an emergency, which is part of why premiums tend to run below a comparable PPO. Network size, referral rules and how the emergency exception is applied vary by plan and by state.
This content is for general informational purposes only and is not insurance, legal, or financial advice. Coverage, exclusions, eligibility, and pricing vary by insurer, by policy, and by state, and only the policy documents control what is covered. Always confirm the details of any coverage with a licensed insurance agent or the issuing carrier before you buy.
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