Wednesday 17 December 2008

HMO or Health Maintenance Organization Coverage

If you are seeking a health insurance quote online, the terminology can be slightly confusing. Getting a health insurance quote online is a wise idea because the online provides have access to all available plans in your area and because they can structure a plan to meet you or your family’s needs.

When selecting a policy it is imperative to know the various forms of insurance. The most popular plans today are called HMO plans. HMO plans are called Health Maintenance Organization plans. In this plan, the member prepays a monthly premium to receive the HMO’s health services and products, all of which are thoroughly explained during the selection process and are itemized in the carrier’s policy. The HMO is responsible for the provision of the services in their policy to their insured members.

The HMO negotiates with physicians, health care providers, hospitals and other industry professionals to provide these services. These entities compose the basic HMO network. The provision of these network services is coordinated by the member’s primary care physician, who the member can select from a list of primary care physicians on their participating physician list.

If the member requires a health related service that is not offered within the network, the member can consult with the health insurance provider who will approve treatment at an out-of-network resource. Use of out-of-network providers can cost the member additional money and in some cases the member may have to pay for the service and apply for compensation from the HMO plan. Most HMO plans require the member to consult with them when using a provider not listed on their roster. In fact, it is a good idea to stay in regular contact with the HMO coordinator when using any medical services.

Consumers should understand that at the core of the HMO plan is the primary care physician. If you are selecting a family plan, you may want to select a primary care physician who has pediatric experience or if someone in the family or if there are four females on your family plan, you may want to select a physician who works with females. The primary care physician coordinates the patient’s care with other physicians and service providers in the plan by issuing referrals to these providers. After a general physical examination, the primary care physician identifies the ailment or condition and refers the patient to a specialist within the HMO plan.

HMO plans are available online. To receive a free, non-binding health insurance quote or quote for HMO coverage, complete a brief questionnaire and allow the online health insurance provider to find suitable plans in your area. Often the recipient will receive multiple quotes from multi0ple carriers and the online provider will assist the candidate in the selection process. Receiving a proposal from an online provider is a cost efficient way to find coverage for you or you family.