HMO

A Health Maintenance Organization (Commonly referred to as an HMO) is a type of managed healthcare program designed to offer substantial healthcare coverage at an affordable price. There are 4 basic categories of health care programs from which to choose from, those being:

• HMO
• Point Of Service (POS)
• Preferred Provider Organization (PPO)
• Indemnity (Fee-for-service)

Of the 4 categories, HMO programs are the least expensive. It is not surprising, therefore, that HMO programs are also the most commonly purchased healthcare plan. (More than 60 million Americans are enrolled in some form of HMO plan) Although HMO programs are extremely common and inexpensive, they only offer a limited degree of access to health care. Members are limited to the care offered within the given HMO network, choosing a network Primary Care Physician (PCP) who will coordinate their care. This includes:

• Routine & preventive care
• Treatment for illness/sickness/injuries
• Referrals to a network specialist or facility when necessary

If your PCP refers you outside of the network, then you are responsible for the paying all incurred costs in full. Your HMO plan encourages you to limit your care to your PCP or some other network affiliate whenever possible.

In 1930's San Francisco, an up-and-coming businessman named Henry Kaiser met with a local San Franciscan doctor. Kaiser was looking to provide health care services for his employees through some sort of group insurance program. This alliance was the origin of the Kaiser Permanente Network, the company touted as the founder of the modern HMO. Today, Kaiser Permanente is the world's largest Health Maintenance Organization with more than 8 million members throughout 9 States.

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