What is HMO medical health insurance?
Reader question:
What is HMO medical health insurance?
Miriam
I’ll tell you.
The main benefit of getting an HMO, or health maintenance organization medical health insurance plan, is that this most popular of employer provided health insurance plans also tends to be the cheapest medical health insurance plan. It’s more designed for group health insurance, which is why it finds such popularity among companies insuring their employees. HMO medical health insurance is also one of the few health insurance plans that puts a lot of emphasis on preventive care.
The reason they put so much emphasis on preventive care is because, the way HMO sees it, is that preventive care can help reduce risks in an insurance pool by decreasing the likelihood that its members will develop a medical conditions, and thus it reduces medical costs. That is why it is the best to help someone stay healthy, not just to help them out if something goes terribly wrong.
The Good:
- The main thing is preventive care, which lowers both their costs and yours. HMOs also require less paperwork, and when you make a co-payment on something it will cost far less than it would with another medical health insurance plan.
- The insured under a health maintenance organization just pay a little fee each time they go to the doctor, and that is considered their co-payment.
- The coverage goes wide, with such things as outpatient services, extended medical treatment, short term mental health treatment, hospital stays, and emergency room visits.
The Bad:
- Picking and choosing the physician that you go to isn’t as easy as with traditional indemnity. Instead, you are only able to pick one provider, and that is who you must go to once he is listed on your insurance.
- The doctor you must pick has to be within the HMOs network. If you go to a hospital or physician outside of the network, then you won’t be covered at all.
- If you want to go outside of the network to see a specialist and still be covered, then you have to have a referral from your primary care provider.
Cheers,
Fashun Guadarrama.
Cheap medical health insurance? Unlikely.
Reader question:
Are medical health insurance prices ever going to go down?
Amber
Probably not.
The system kind of works against itself. Medical care costs a lot, and people need medical health insurance companies to help them pay for it. At the same time, though, medical health insurance drives up medical bill costs, and it just keeps on chasing itself around in a circle. Circles don’t end, so the likelihood that medical health insurance or health care costs will go down anytime in the near future short of a miracle is very unlikely.
The most important thing to do when looking for a medical health insurance plan is to shop around and compare quotes from different companies. This can often be done on the internet, where quote comparison sites save you a lot of time and money by comparing quotes from several different companies.
Still, once you get a quote and take out a medical health insurance policy, don’t expect that you will be paying the same forever. Insurance companies do everything they can to charge more money, and in many states its very easy to increase prices without any pre-approval. Often, a health insurance company can just send in a request to increase rates and they can immediately start charging those increased rates without an answer, and can only be stopped if they are reviewed and it’s decided that they charge too much.
Your rates could go up even if you don’t make any health insurance claims and are part of a group health insurance plan. The reason this could happen is that somebody else in your group may be making health insurance plans, and then the rates will raise for everybody, no matter in what good health you are. Rates in group health insurance are decided by the group’s total average history, not your individual claim history.
Cheers,
Fashun Guadarrama.