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In the United States, a health maintenance organization (HMO) is a medical insurance group that provides health services for a fixed annual fee. [1] It is an organization that provides or arranges managed care for health insurance , self-funded health care benefit plans, individuals, and other entities, acting as a liaison with health care ...
In practice, an HMO is a coordinated delivery system that combines both the financing and the delivery of health care for enrollees. In the design of the plan, each member is assigned a "gatekeeper", a primary care physician (PCP) responsible for the overall care of members assigned. Specialty services require a specific referral from the PCP ...
The term has sometimes been used in a broad sense with reference to managed care in general (as opposed to fee-for-service care), but in the United States it now more often refers to any specific network of health care organizations constituting a corporate group that attempts to integrate care to some degree (that is, to coordinate the patient ...
A person enrolled in a Medicare Advantage HMO plan must generally pay the premium for Medicare Part B, and a plan premium. However, some HMO plans help pay a percentage of the Medicare Part B premium.
HMO. Health Maintenance Organization plans are often considered the most affordable insurance option. With low deductibles and low copays for doctor visits and pharmaceuticals, HMOs are affordable ...
State availability: all 50 states Plans available: HMO, PPO, PFFS, SNP CMS star rating: 4 stars The Medicare Advantage plans from Humana include HMOs, PFFS, PPOs, and SNPs, depending on your location.
The IPA assembles care providers in self-directed groups within a geographic region to invent and implement health improvement solutions, form collaborative efforts among care providers to implement these programs, and exert political influence upward within the community to effect positive change.
Over half (56%) are health maintenance organization (HMO) plans. However, preferred provider organization (PPO) plans are increasing in popularity (up from 24% in 2017 to 42% in 2024). Plans ...