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Health Maintenance Organizations (HMOs)

An HMO is a managed care plan that provides medical care through its network of physicians, pharmacies, contracted hospitals, and medical care suppliers. You can choose your own primary care physician who will provide direct care or make referrals from within the network. An HMO provides necessary hospital and medical treatment when you are sick or injured, prescription medicine services, substance abuse treatment, short-term mental health care, and routine preventive health maintenance services such as immunizations. When you see a HMO in-network provider for covered services, your out-of-pocket costs are limited to deductibles (starting October 12, 2014), and copays.

You may enroll in an authorized HMO plan serving your residential area. You may look up HMOs in your residential area using the zip code tool. Utilize the Insurance Plans page to review plan summaries or contact the HMO that interests you to request their benefit booklet. If you are new to an HMO, that HMO may ask you to select your primary care physician. Respond promptly to the carrier to complete the final phase of the enrollment process.