An HMO is a type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO. An HMO generally won’t cover or has limited coverage for out-of-network care, except in an emergency. HMO members usually have a primary care doctor and must get referrals to see specialists. HMOs often provide integrated care and focus on prevention and wellness. In general, HMO plans are the least expensive plans that health insurance carriers offer.
Some HMO plans have broad provider networks while others have narrow (or basic) provider networks:
A broad provider network means that comparably more providers, hospitals and pharmacies contract with the HMO network. Broad HMOs are typically more expensive than narrow HMOs because they offer more choice for members to select where and from whom they receive their care and prescription drugs.
A narrow provider network means that comparably fewer providers, hospitals and pharmacies contract with the HMO network. Narrow HMOs are typically the least expensive HMO plans because patients have more limited options to select where and from whom they receive their care and prescription drugs.