Health Maintenance Organization (HMO) (HMO)

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Healthcare

Health Insurance

A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO. It generally won't cover out-of-network care except in an emergency. An HMO may require you to live or work in its service area to be eligible for coverage. HMOs often provide integrated care and focus on prevention and wellness.

A type of managed care organization (health plan) that provides health care coverage through a network of hospitals, doctors and other health care providers. Minn. Statutes, Chapter 62D govern HMOs and are under the jurisdiction of the Minnesota Department of Health.

Prepaid health plans in which you pay a monthly premium and the HMO covers your doctor's visits, hospital stays, emergency care, surgery, preventive care, checkups, lab tests, X-rays, and therapy. You must choose a primary care physician who coordinates all of your care and makes referrals to any specialists you might need. In an HMO, you must use the doctors, hospitals and clinics that participate in your plan's network.

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