How HMOs work
An HMO (Health Maintenance Organization) plan uses a defined network of doctors and hospitals. You pick a primary care provider (PCP) who coordinates your care and refers you to specialists when needed.
Meet your guide
HMO
I break down HMO plans, primary care doctors and referrals.
What HMO can teach you
The trade-off: lower cost, narrower network
HMOs often have lower premiums and predictable copays. The trade-off is that out-of-network care usually isn't covered except in emergencies. We check that your doctors are in-network before recommending a plan.
Referrals and prior authorization
Most HMOs require a referral from your PCP to see a specialist, and some services need prior authorization. Knowing the rules in advance keeps surprise bills off the table.
Frequently asked questions
Can I keep my current doctor?
Only if your doctor is in the plan's network. We check this carefully before you enroll.
What happens if I go out-of-network?
In most cases you pay the full cost yourself — except for emergencies, which are always covered.
Why are HMO premiums often $0?
Carriers can offer low or $0 premiums because the network is narrower and care is coordinated through your PCP, which controls costs.
Still have questions about HMO plans?
Talk with a real person — no pressure, just clear answers.