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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.
What happens if you see a doctor outside of your network? ›If your insurance company provides out-of-network coverage, it may only pay the amount it would for an in-network service. As a result, you could owe a greater percentage of your care in the form of higher copayments and coinsurance when you go to out-of-network providers.
What is HMO vs PPO? ›HMO plans typically have lower monthly premiums. You can also expect to pay less out of pocket. PPOs tend to have higher monthly premiums in exchange for the flexibility to use providers both in and out of network without a referral.
What is the difference between HMO and HMO POS? ›Most HMOs provide care through a network of doctors, hospitals and other medical professionals that you must use to be covered for your care. With an HMO-POS you can go outside of the network for care, but you'll pay more. You'll need to choose a primary care physician (PCP) to coordinate all your care.
What would not be considered in or out of network by health insurance plans? ›Health insurance plans consider pharmacies, hospitals, and doctors in or out of network, but not health food stores.
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