HMO stands for Health Maintenance Organization. HMO plans must go to network providers to get medical care and services. Members must select a primary care physician within the provided network and require a PCP referral before seeing a specialist. That doesn't mean they can't ever see a doctor who's outside the HMO network. But, unless it's an emergency, the member may have to pay the total cost for their medical care.

Question

HMO stands for Health Maintenance Organization. HMO plans must go to network providers to get medical care and services. Members must select a primary care physician within the provided network and require a PCP referral before seeing a specialist. That doesn't mean they can't ever see a doctor who's outside the HMO network. But, unless it's an emergency, the member may have to pay the total cost for their medical care.

Which of the below statements are generally true about Health Maintenance Organization plans (HMO plans)? Select all that apply.

Answer 1

1. Members must select a primary care physician within the network.

2. Members need a PCP referral before seeing a specialist.
3. Members can see any doctor they choose without needing approval.
4. Emergency care is covered even if it's outside the network.