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How HMO Plans Work

Under most HMO Plans, you are limited to choosing your doctors and other care providers from within your plan’s network. Some plans may allow you to choose out-of-network doctors or other care providers for specific services called “point-of-service” or POS. 

Those with HMO Plans may also get services outside of their network’s plan when it comes to things like emergency care or urgent care outside of your area.

HMO Plan Cost

HMO Plan costs are generally lower than PPO Plans. Still, costs vary depending on your plan and whether you have a plan that allows for services outside your network. To avoid being subject to increased out-of-pocket costs, make sure to know what your plan covers, and learn about costs associated with seeking services outside of your network. At Cashmore Financial Group, we can help you navigate these plans.

Benefits of HMO Plans

HMO Plans are typically lower in costs compared to PPO Plans. HMO Plans generally offer prescription drug coverage, also known as Medicare Part D. That is not always the case. However, be sure to confirm your plan offers Part D coverage. 

Cons of HMO Plans

There are many considerations to make before going with an HMO Plan. The first consideration is that under most HMO Plans, you are limited to choosing doctors and other healthcare services from within your network plan. In the case that your doctor or care provider leaves your network, you will have to choose another doctor or care provider within your network. Under HMO Plans, you are required to choose a primary care physician. Those with HMO Plans also need to obtain referrals for specialist care. 

For HMO Plans that allow you to go outside of your network’s plan for healthcare, you may be subject to paying the full cost associated with those services. 

Learn More about HMO Plans

With many considerations to make before deciding if an HMO Plan is right for you and your healthcare needs, we at Cashmore Financial Group are here to help. Give us a call today to discuss your options.

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