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Simple English definitions for legal terms
health-maintenance organization
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A quick definition of health-maintenance organization:
A health-maintenance organization, or HMO, is a group of healthcare providers who offer medical services to people who are enrolled in a group health-insurance plan. This means that if you are a member of an HMO, you can go to certain doctors and hospitals to receive medical care. HMOs are different from other types of healthcare plans, like preferred-provider organizations, or PPOs.
A more thorough explanation:
A health-maintenance organization, also known as an HMO, is a group of healthcare providers who offer medical services to members of a group health-insurance plan. HMOs are designed to provide affordable healthcare to individuals and families by offering a network of healthcare providers who have agreed to provide services at a reduced cost.
- John is a member of an HMO and can only receive medical care from healthcare providers within the HMO's network. This means that he cannot see a doctor outside of the network unless it is an emergency.
- Sarah's employer offers an HMO as part of their employee benefits package. Sarah can choose to enroll in the HMO and receive medical care from the providers within the network.
These examples illustrate how HMOs work by providing a network of healthcare providers who offer medical services to members of the plan. Members are typically required to choose a primary care physician within the network who will coordinate their medical care and refer them to specialists within the network when necessary. HMOs are a popular choice for individuals and families who want affordable healthcare coverage.