HMO (Health Maintenance Organization)
Health plan with closed network and primary care gatekeeper for specialist referrals.
Full explanation
An HMO is a health plan structure where you must use providers in the plan's network (no out-of-network coverage except emergencies) and typically need a primary care physician (PCP) referral to see a specialist. HMOs usually have lower premiums than PPOs in exchange for the network restrictions. Common in Medicare Advantage and ACA marketplace. Best fit if you live in a stable location with quality in-network providers and don't need flexibility to see any provider.
📎 Primary source: official source
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