HMO (Health Maintenance Organization)

An HMO is a Health Maintenance Organization - a system of managed healthcare created in the 1980's to control costs.  The idea was to require members to use a "Primary Care Physician", and to use certain Hospitals and other Providers in a Network, who had contracted with the Insurance Company to accept discounted rates, and to control over-utilization through managed healthcare.  During the 1980's and 1990's, it provided lower-cost insurance plans, with higher benefits.  Today, it is almost obsolete.  However, it is still a valid option for those who want an Individual / Family plan that includes maternity coverage.

An Open Access HMO (OAHMO) does NOT require you to select one Primary Care Physician (PCP), to refer you to Specialists.  You must still use the Network of Providers, but you are given more freedom to choose a variety of Providers from the Network.

Difference between an HMO and PPO

What is a POS

What is a PPO

Last updated 2/2/2007