HMO Eligibility

When choosing a health care plan, many people join health maintenance organizations (HMOs) for the predictable co-payment costs and because there is no deductible payment that needs to be met. However, HMOs also come with limitations, and interested parties should know what that means before joining an HMO.

HMOs

• HMOs are a health care organizational and payment system for those who are eligible. HMOs are arranged not only to help pay for care, but to also align patients with doctors and medical facilities to treat certain ailments.

Eligibility

• Whether or not you are eligible for HMO coverage depends on where you live, where you are employed, and the enrollment requirements for different HMO programs. For example, an HMO might be limited to only a certain state or certain company. As all HMOs have different coverage, those interested in joining one should first research different plans to figure out which one is best for them.

Limitations

• Members of a certain HMO plan will be restricted to seeing only doctors who are part of that program. If members decide to seek heath care elsewhere not under their HMO, they are likely to pay most or all of the medical costs for that visit and treatment themselves.