Definitions for "HMO"
Related Terms:
Health maintenance organization, Health maintenance organizations, Exclusive provider organization, Managed care plans, Network, Managed care organization, Epo, In-network provider, Closed panel, Independent practice association, Preferred provider organizations, Out-of-network provider, Individual practice association, Nonparticipating provider, Preferred provider organization, Ppo, Managed care plan, Staff-model hmo, Managed care, Provider network, Participating physician, Managed health care, Covered entity, Network provider, Point of service plan, Preferred provider network, Medicare hmo, Participating provider, Alternative delivery systems, Point-of-service plan, Pso, Dhmo, Php , Closed access, Mco, Dental health maintenance organization, Carve-out, Out-of-network care, Non-participating provider, Medicare part b, Part b, Medicare managed care plan, Out-of-network, Out-of-network services, Pccm, Prepaid health plan, Group model hmo, Provider sponsored organization, Point-of-service, Fee-for-service plan
Health Maintenance Organization. A form of health insurance combining a range...
A health maintenance organization; a form of group health insurance that entitles members to services of participating hospitals and clinics and physicians.
A type of managed care plan. HMOs provide a full range of services to members.Members must receive all care from HMO network providers. A primary care physician oversees all health care decisions and makes referrals.You pay monthly premiums and co-payments for office visits. Generally,HMOs have a select list of providers, a limited choice of hospitals, and an emphasis on preventive care.
A type of managed care plan that generally covers only the care you get from doctors, hospitals, and other health care providers that are in the HMO network. The government pays HMOs a set amount to provide health care to people with Medicare. HMO members must choose a primary care doctor who coordinates their care and decides when they can go to a specialist.
Health care centers that stress preventive health care, early diagnosis, and treatment on an outpatient basis. An organized system of health care delivery and financing that provides a broad range of services to a voluntarily enrolled group for a fixed and periodic payment. The HMO participant pays a flat annual premium and is entitled to medical check-ups and routine health care, plus major medical coverage.
( ealth aintenance rganization) is a benefit package option under the medical insurance plan.
A form of managed care in which the member selects a primary care physician to coordinate all care, and agrees to use a defined network of doctors and hospitals for all services.
A prepaid medical group insurance plan that provides a comprehensive predetermined medical care benefit package.
a health plan that uses a network of participating providers. Participants must use these providers for all medical care in order for the services to be covered.
Originally, an HMO was defined as an organization that provided health care to members in return for a preset amount of money. Today the term encompass two possibilities: a health plan that places at least some of the providers at risk for medical expenses, and a health plan that utilizes primary care physicians as gatekeepers (although there are some HMOs that do not).
A form of insurance, which provides benefits through specified providers who are under contract only. HMO's control costs by paying providers on a capitated rate regardless of the actual services provided.
Health Management Organization
Health care delivery system that typically uses contracted primary care physicians to coordinate all health care for enrolled members. HMOs require you to select a primary care physician (PCP). The PCP coordinates your care and refers you to specialists and hospitals. Covered services are usually paid in full after you pay any required copayment. No claim forms are required. An HMO option does not allow you to use providers outside of the HMO.
ealth aintenance rganization is a managed care plan where the member uses a Primary Care Physician from a network of providers to coordinate care. Coverage is provided only for care received in the network.
An organization that requires referrals to Primary Care Physicians (PCP) prior to any visit to a specialist or treatment at a medical facility.
A public or private organization that provides healthcare in return for pre-set monthly payments. Most HMOs provide care through a network of doctors, hospitals and other medical professionals that their members must use to be covered for that care.
An organization that assumes responsibility for providing health care to members for a fixed payment without regard to the amount of actual services provided to an individual enrollee. The HMO is responsible for providing most health and medical care services required by enrolled individuals or families, and these services are specified in the contract between the HMO and the enrollees.
a health plan that provides coverage for treatment by a network of doctors, hospitals and other health care providers within a certain geographic area. HMOs do not offer out-of-network benefits.
Refers to purveyors of managed healthcare.
Health management organisation
Company that pays for you to get physical health care.
A type of Medicare managed-care plan where a group of doctors, hospitals, and other health care providers agree to give health care to Medicare beneficiaries for a set amount of money from Medicare every month. You usually must get your care from the providers in the plan
An HMO is a managed health care plan that provides, or arranges, for the delivery of comprehensive, coordinated medical services to voluntarily enrolled member on a prepaid basis.
Health Maintenance Organization Prepaid providers of healthcare with services that mirror Medicare services
Health Maintenance Organization. HMOs usually limit coverage to care from doctors who work for or contract with the HMO. They generally do not require deductibles, but often do charge a copayment for doctor visits or prescriptions. If you are covered under an HMO, the HMO might require an affiliation period before coverage begins.
Health Maintenance Organization. A health care plan that provides comprehensive medical care for a fixed annual fee in a specific geographic area. With the exception of emergency care outside the HMO’s service area, most services must be provided by the HMO’s doctors, hospitals and other providers to be covered under the HMO plan. Physicians and other providers are paid a salary or have a contract with the HMO to provide services.
Health Maintenance Organization. A health insurer or provider that offers comprehensive services on a prepaid basis. The HMO contracts or directly employs physicians to serve as its network. Physicians are paid a salary, reduced fees, or capitated rate for services. Patient choice is limited to contracted physicians to a varying degree depending on the type of organization. Types of HMO models: Group Model - contract with medical groups for services. IPA Model - contract with an IPA that in turn contracts with individual physicians. Staff Model - a health care model that employs physicians to provide health care to its members. All premiums and other revenues accrue to the HMO which compensates physicians by salary and incentive programs. Direct Contract Model - contracts directly with individual physicians. Mixed Model - members get options ranging from staff to IPA models. Network Model HMO - contracts with more than one physician group, and may contract with single and multi-specialty groups. Open-Ended HMO - a product that allows members to use physicians outside the plan in exchange for additional personal liability in the form of a deductible, coinsurance, or copayment.
Health Maintenance Organization. A managed care plan that both finances health care services for its subscribers on a prepayment basis and organizes and provides health care services directly through its own employed or contracted health care providers.
A Health Maintenance Organization is a health plan that provides care from specific doctors and hospitals that contract with the plan. Usually there are no claim forms to be completed and there is often a geographically-restricted service area.
Health Maintenance Organization, this almost always means that in exchange for lower monthly premiums and out of pocket expenses than competing health plans, the employee must follow a stringent set of rules and guidelines pertaining to receiving medical services
Health Maintenance Organization. A managed care plan that combines the functions of insurer and provider of care, giving most necessary care for a prepaid fee and placing an emphasis on prevention and careful assessment of medical necessity.
Health Maintenance Organization. A form of health care which provides services for a fixed period on a prepaid basis.
Health maintenance organization. A medical plan that offers services through specific physicians, hospitals, and other health care professionals. To receive HMO plan benefits, you must use participating HMO doctors and facilities.
Health Maintenance Organization. A system of health care delivery in which all the health care services its members need are offered within all the HMO system. HMO's therefore may not agree to refer or financially cover health care professionals or services outside of their HMO system.
Health Maintenance Organization. A legal corporation that offers health insurance and medical care. HMOs typically offer a range of health care services at a fixed price.
Health maintenance organization. A health care plan where all medical services are provided by an organization of health care providers, hospitals, etc. Individuals covered in the HMO must use the providers authorized except in emergencies. A primary care physician (PCP) is appointed, and enrollees must see their PCP unless an authorized referral is made to specialists with the HMO. The advantage of an HMO is that there are no deductibles and normally only requires a small copayment for each medical encounter.
health maintenance organization; an insurance plan in which you choose a primary care physician who must approve referrals to other providers
Health maintenance organization. A system for providing comprehensive prepaid health care in which providers deliver health services to a group of subscribers at a predetermined cost.
Health maintenance organization. A health care financing and delivery system that provides comprehensive health care services for enrollees in a particular geographic area. HMOs require the use of specific plan providers.
Health Maintenance Organization. Although it originally was intended to specify organizations like Kaiser Permanente that emphasize preventive care, the term HMO is now widely applied to many other kinds of managed care organizations.
HEALTH MAINTENANCE ORGANIZATION. A managed care plan that combines the function of insurer and provider to give members comprehensive health care from a network of affiliated providers. Enrollees pay limited copayments and are usually required to select a primary care physician through which all care must be coordinated. HMOs generally will not pay for services obtained from a non-network provider or without a primary care physician's referral. HMOs often place an emphasis on prevention and careful assessment of medical necessity.
Health Maintenance Organization. Aetna offers various HMO plan designs with varying copayments. Except for direct access programs, emergency situations and for out-of-area urgent care, members may access health care services only through their chosen primary care physician (PCP). The PCP coordinates all aspects of a member's care covered under the plan. Specialty or facility services are not covered unless approved or directed in advance by the member's PCP. | | | | | | | | I-L | | | | P-Q | | | T-Z
Health Maintenance Organization. An alternative to commercial insurance that stresses preventive care, early diagnosis and treatment on an outpatient basis. HMOs are licensed by the state to provide care for enrollees by contracting with specific health care providers to provide specified benefits. Many HMOs require enrollees to see a particular primary care physician (PCP) who will refer them to a specialist if deemed necessary.
A type of medical insurance coverage that specifically states which doctors and medical institutions patients may use and which medical tests and procedures will be paid for by the HMO.
Health maintenance organization. A type of managed care plan that acts as both insurer and provider of a comprehensive set of health care services to an enrolled population. Services are furnished through a network of providers (such as physicians and hospitals).
Health Maintenance Organization. Organization that provides for a wide range of comprehensive health care services for a specified group of enrollees for a fixed, periodic prepayment. There are several models of HMOs including the staff model, group model, independent practice association, and mixed model.
Health Maintenance Organization. The health maintenance organization (HMO) is a comprehensive prepaid system of health care with emphasis on the prevention and early detection of disease and continuity of care.
Health Maintenance Organizations. HMOs are a type of managed care plan. Members of HMOs choose a primary care physician who will coordinate their routine medical care and provide treatment for a variety of conditions. The primary care physician authorizes referrals to specialists and non-emergency visits to hospitals. HMO members must use health care providers in their network, but have minimal or no deductibles and lower out-of-pocket costs than other health care plans.
A healthcare service plan that requires its subscribers or members, except in a medical emergency, to use the services of designated physicians, hospitals or other providers of medical care.
A Health Maintenance Organization (HMO) is an organized system for providing comprehensive health care in a specific geographic area to a voluntarily enrolled group of members.
Health Maintenance Organization. An organization set up and operated to provide health services under a pre-paid or Capitated arrangement; monthly fees to the HMO remain the same regardless of the types or levels of service provided.
Health Maintenance Organization. The oldest form of managed health care. In exchange for a monthly fee, HMOs offer members a comprehensive range of health services, usually including preventive medical care.
Health maintenance organization. A managed care system that provides services to members through a network of physicians, hospitals, and other health care providers. HMOs eliminate the need to file claims in most cases by allowing members to "prepay" through monthly premiums and copayments made as services are delivered.
As previously described, an HMO covers your physician visit(s), hospital stay(s), emergency and other medical treatments, but has certain restrictions that govern the policy. You must use the physicians and hospitals designated by the HMO. (The insurance provider will give you a list of physicians to choose from.) In addition, an HMO stipulates that you will need to go to a primary care physician and get a referral if you’re in a situation where you need further testing or visits with a medical specialist.
Health Maintenance Organization. An organization that provides a wide range of comprehensive health care services through a designated group, or network of doctors, hospitals, labs and other providers. When you join an HMO, you select a Primary Care Physician (PCP) from its staff or from a list of PCPs. Your Primary Care Physician is responsible for coordinating all of your medical care. Referrals to specialists and hospital admissions are arranged by your Primary Care Physician or the HMO company. There are two basic types of HMOs – Staff Model HMOs and Network HMOs. A HMO can be a mixture of the two types. In the staff model HMO, a group of physicians is employed directly by the HMO and practice from a facility that is provided by the HMO. In other HMOs, an independent network of physicians is recruited and contracted by the HMO and practice from health facilities not provided by the HMO.
Health Maintenance Organization. A public or private organization providing, either directly or through arrangements with others, a comprehensive range of health services to enrolled members who live within a specified service area. Payment is based on a predetermined periodic rate, or periodic per capita rate, without regard to the frequency or extent of covered services furnished to any particular member. The HMO must also meet statutory requirements.
health maintenance organization. a group health insurance plan offering prepaid medical care to its members
Health Maintenance Organization. A health plan that offers comprehensive health coverage to its members for both hospital and physician services for a fixed fee (an amount per member per month), with a small amount collected at the time of each visit. An HMO contracts with health care providers, e.g., physicians, hospitals and other health professionals, and members are required to select a primary care physician from among the network providers, and to use network providers for all health services. Model types include staff, group practice, network and IPA (see separate definitions).
Health maintenance organization. When you sign up for an HMO, you choose one doctor to coordinate all your healthcare. This doctor, your "primary care physician," learns your entire medical history. He or she recommends care based on knowing you from head to toe. If you should ever need care from a specialist, your primary care physician will refer you to one in your health plan's network.
Health maintenance organization. HMOs are the least expensive, but also the least flexible of all the health insurance plans. They are geared more toward members of a group seeking health insurance. HMO advantages: They offer their customers low co-payments, minimal paperwork, and coverage for many preventive-care and health improvement programs. HMO disadvantages: You must choose a primary care physician, also known as a PCP; HMOs require that you see only network doctors; you must get a referral from your PCP to see a specialist
Health Maintenance Organization. An organization that offers pre-paid, comprehensive healthcare coverage to members for hospital physician services and ancillary services. Medical care and services must be received from participating providers. When care is rendered by participating providers, members are usually only charged a small co-payment or fee for office visits and other medical services. Benefits are generally not available for non-emergency services obtained from non-participating providers.
Health Maintenance Organization is a type of managed care plan that typically works in the following manner: The HMO consists of a network of “capitated” health care providers, which means these providers receive set monthly payments for each plan member (such as your employees), regardless of how frequently their services are used. Employees are required to choose a Primary Care Physician (PCP) to perform many of their health care services and refer them to specialists when necessary. They are only referred to specialists within the HMO's network, except in special circumstances. Employees are typically only responsible for a small co-payment for visits to their PCP or specialists to whom they've been referred. In most cases, no deductible is required. If employee visits another physician without a referral from their PCP, they won't receive any coverage, except in certain emergencies.
Health Maintenance Organization. An organization which arranges a wide spectrum of health care services which commonly include hospital care, physicians' services and many other kinds of health care services with an emphasis on preventive care.
Health Maintenance Organization. An organization that provides a wide range of comprehensive health care services for a specified group at a fixed periodic payment. The HMO can be contracted with and sponsored by the government, medical schools, hospitals, employers, labor unions, consumer groups, insurance companies, and hospital-medical plans.
Health Maintenance Organization. A type of managed health care system that contracts with medical facilities, physicians, employers, and sometimes individuals to provide medical care to a group of people known as "members." Generally, members of HMOs don't have any significant "out-of-pocket" expenses because the medical care is most often paid for by an employer at a fixed price per patient.
Health Maintenance Organization. An entity with four essential attributes: (1) an organized health care system in a defined geographic area that accepts the responsibility to provide or otherwise ensure the delivery of (2) an agreed-upon set of basic and supplemental health maintenance, prevention, treatment, and rehabilitation services to (3) a voluntarily enrolled group of persons, and (4) for which services the entity is reimbursed through a predetermined fixed periodic prepayment made by, or on behalf of, each person or family unit enrolled. Six types of HMO models have been defined
Health Maintenance Organization. A legal entity that accepts responsibility and financial risk for providing specified services to a defined population during a defined period of time at a fixed price. An organized system of health care delivery that provides comprehensive care to enrollees through designated providers. Enrollees are generally assessed a monthly payment for health care services and may be required to remain in the program for a specified amount of time.
Health Maintenance Organization. A type of US health insurer that focuses on maintaining your health, rather than curing diseases.
Health Maintenance Organization. A third party, usually a legal entity, which arranges payment for the provision of basic and supplemental health services to its members from a network of independently contracted providers and facilities on a prepaid or reduced fee basis. Members are required to select a primary care physician to provide routine care, and provide referrals for specialty and hospital services when appropriate.
Health Maintenance Organization†is a type of group health plan in which an organization is formed to provide medical care to its members. The physicians and medical personnel work for the HMO and provide medical care to the members of the HMO, with limited referrals to outside specialists. There is often an emphasis on prevention of disease and participation in programs for better health. Recently, members of HMOs may see health care professionals outside of their system, with higher fees. Members usually obtain all of their medical needs from their HMO clinics through managed medical care.
Health Maintenance Organization. A managed care health plan that provides services through a fixed network of health care providers who provide comprehensive health care coverage to enrolled members exclusively through the network, with some copayments. All care is provided through a network of providers (primary care physicians, specialists, ancillary service providers, and hospitals).
Health Maintenance Organization. Prepaid health plans that work with a network of hospitals and doctors to provide a wide range of health services to their members. For a monthly premium, the HMO covers your doctor visits, hospital stays, emergency care, surgery, checkups, lab tests, x-rays, and therapy. You are required to use the doctors and hospitals designated by the HMO. There are three types of HMOs, which are called group model, staff model, and independent practice associations (IPA).
Health Maintenance Organization. Organization which provides, or ensures the delivery of, a specified set of prevention, treatment, and rehabilitation services to enrollees for a prepaid amount of money.
Health Maintenance Organization. HMOs are also known as managed care plans. These plans typically offer a full selection of health-care benefits, including routine physicals and vision examinations, at the most affordable premiums. HMOs have a smaller selection of physicians. A primary care provider (PCP) is required to coordinate all your health-care needs.
AN ORGANIZATION OF HEATH PROVIDERS. EACH MEMBER PAYS A PREMIUM FOR WHICH HE RECEIVES MEDICAL CARE WHEN DESIRED. THE EMPHASIS IS ON PREVENTIVE MEDICINE.
Health Maintenance Organization. An HMO is a prepaid health plan delivering comprehensive care to members through designated providers, having a fixed monthly payment for health care services, and requiring members to be in a plan for a specified period of time (usually 1 year).
Health maintenance organization. A prepaid health care plan. The HMO provides a complete set of basic and supplemental health services, including physicians, specialists, inpatient facilities, outpatient facilities and, often, prescription drugs. Subscribers voluntarily enroll and prepay a fixed amount of money at regular intervals.
Health Maintenance Organization. A health plan that provides care through contracted or employed physicians and hospitals located in particular geographic or service areas. HMOs emphasize prevention and early detection of illness. Your eligibility to enroll in an HMO is determined by where you live or, in some plans, where you work.
Health Maintenance Organization. Participants receive medical services from a specified list of in-network providers. The services are contracted and access to speciality care is authorized by a primary care physician.
A state-licensed health maintenance organization that delivers physician and hospital services to members directly or through contracts with affiliated providers. The plan requires members to choose a network provider (a primary care physician) to coordinate their health care.
Health Maintenance Organization. A type of health benefits plan that provides care through a network of doctors and hospitals in particular geographic or service areas. HMOs coordinate the health care services you receive. Your eligibility to enroll in an HMO is determined by where you live or, for some plans, where you work. Some FEHB HMOs have agreements with providers in other service areas for non-emergency care if you travel or are away from home for extended periods.
Health Maintenance Organization. a network of hospitals, doctors and other medical providers who provide services through an HMO plan.
Health Maintenance Organization. A pre-paid fee gives members comprehensive health care from pre-selected physicians for a minimal co-payment ($5-$15 co-pay). http://www.iha.org/gloss.htm
Health Maintenance Organization. is the most common form of managed care. All health services are delivered and paid for through one organization, often under one roof. An HMO requires its participants to use only certain health providers and hospitals, usually those within its own network.
Health Maintenance Organization. A managed care business that organizes health care services for its members. HMOs have three distinct features: Use of primary care providers to coordinate patient care and act as gatekeepers Members required to use designated providers and facilities Payments to providers often involve capitation
Health Maintenance Organization. An HMO (Health Maintenance Organization) is an organization that provides one type of health insurance. The HMO has agreements with certain doctors and hospitals to give members of the HMO medical care at a reduced cost. An HMO will give you a list of doctors, and you must choose one. With some HMOs, you will pay nothing when you visit a doctor. With other HMOs, you may have to pay a copayment.
Health Maintenance Organization. Provider and insurer that accepts full risk capitation and aims, among other things, to be more efficient by emphasizing prevention and utilizing case managment services. All | | | | | | | | | | | | | | | | | | | | | | | | | | | Other Glossary V1.5 Polls As of August 25th 2005 are you visiting this site as a..... Family member? RT? RN? PT? OT? ST? Case Manager? MD? Patient? Clergy? Social Worker? Other? Statistics since Febuary 2005
Health Maintenance Organizations. Pre-paid or capitated insurance plans in which individuals and/or their employers pay a fixed monthly fee for services instead of separate charge for each visit or service.
Health Maintenance Organization. A type of insurance plan.
Health Maintenance Organization. Managed care health plan that uses an established network of health care providers - doctors, specialists, hospitals, laboratories and pharmacies in which provider network participants have agreed with the insurance carrier to provide health care services for a negotiated price. Generally, the only out-of-pocket expense for the patient is a small co-payment made at the time the service is received. In an HMO, the patient must choose a Primary Care Physician (known as a PCP) who provides most services and must authorize the use of other services, such as hospitalization, referrals to specialists and testing.
Health Maintenance Organization. An organization that provides a wide range of comprehensive health care services for a specified group at a fixed payment. Hospitals, employers, labor unions, consumer groups, insurance companies, can sponsor the HMO and hospital-medical plans.
Health Maintenance Organization. An organization that provides health care services to a specific group of people for a fixed periodic prepayment.
Health maintenance organization. an organization that provides health care for a monthly payment set in advance. In a traditional HMO, doctors and other providers are salaried employees and the facilities are owned by the organization. In recent years, however, other forms of HMOs have sprung up that contract with doctors and hospitals to care for members at set, negotiated fees. Many HMOs are hybrids, offering both kinds of care to members. Return to Menu
Health Maintenance Organization. An organization set up and operated to provide health services according to applicable federal or state HMO laws.
Health Maintenance Organization. HMOs offer prepaid, comprehensive health coverage for both hospital and physician services. An HMO contracts with health care providers, e.g. physicians, hospitals, and other health professionals, and members are required to use participating providers for all health services. Members are enrolled for a specified period of time. Model types include staff, group practice, network and IPA.
Health maintenance organization. A health care system that assumes or shares both the financial risks and the delivery risks associated with providing access to in-network medical services to members in a particular geographic area, usually in return for a fixed, prepaid fee.
Health maintenance organization. An insurance-like plan for providing health care, including preventive health care, on a prepaid basis to subscribing members of the plan.
Health Maintenance Organization. An entity that provides, offers or arranges for coverage of designated health services needed by members for a fixed, prepaid premium. There are three basic models of HMOs: group model, individual practice association (IPA), and staff model.
health maintenance organization. An organization that provides comprehensive health care services for subscribing members in a particular geographic area. People enrolled in an HMO pay dues in return for the right to health care services at a lower-than-average cost. See also group practice model (GPM) and individual practice association (IPA).
Health Maintenance Organization. Once considered the "wave of the future" in health care, HMOs were originally praised for keeping patients healthy, by emphasizing check-ups and other preventive care. The concept was that--even though all needed treatment was still theoretically covered--healthier patients would need fewer expensive treatments. However, some HMOs are now known for a reluctance to pay for advanced treatment. There are different types of HMOs, including group models, IPAs, network models, and combinations.
Health Maintenance Organization. Prepaid group health insurance plan that entitles members to services of participating physicians, hospitals, and clinics. Emphasis is on preventative medicine. Members of the HMO pay a flat periodic fee (usually deducted from each paycheck.
Health maintenance organization. A medical plan that offers its members a wide range of medical services from a specific group of medical providers.
Health Maintenance Organization A health care payment and delivery system involving networks of doctors and healthcare institutions. It offers consumers a comprehensive range of benefits at one annual fee (often with co- payments or deductibles that vary from service to service) but they can see only providers in the network. Physicians and other health professionals often are on salary or contract with the HMO to provide services. Patients are assigned to a primary care doctor or nurse as a "gatekeeper" who decides what health services are needed and when.
Health maintenance organization. A managed care plan that contracts with a group of physicians, other health care professionals and hospitals (known as a network) to care for its patients (known as members). Members usually must select a primary care physician from the network and call or see this doctor first for all medical care.
Health Maintenance Organization. An entity that offers prepaid, comprehensive health coverage for both hospital and physician services with specific health care providers using a fixed structure or capitated rates.
Health Maintenance Organization. An organization that arranges for a network of physicians, health care practitioners and facilities to provide a wide spectrum of health care services to members covered under contracts issued by the HMO. Our HMOs include: MD-Individual Practice Association, Inc. (MD IPA), Optimum Choice, Inc.(OCI) and Optimum Choice of the Carolinas, Inc. (OCCI).
Prepaid health plans in which you pay a monthly premium and the HMO covers your cost of care to see doctors within their network at pre-negotiated rates. You must choose a primary care physician who coordinates all of your care and makes referrals to any specialists you might need. If you are an HMO member and you do not use the doctors, hospitals and clinics that participate in your plan’s network, you will usually bear the cost of those medical services.
Health Maintenance Organization. An organization that has made agreements with doctors and other health care professionals to provide preventive and sick care to members at a low preset fee.
Health maintenance organization. An HMO is a formally organized system that integrates the delivery and financing of health care services.
Health maintenance organization. A comprehensive health care financing and delivery organization that provides or arranges for provision of covered health care services to a specified group of enrollees, at a fixed periodic payment, through a panel of providers. Historically, four types of HMO models have been common: 1) staff model in which physicians are salaried employees of the HMO; 2) group model, which contracts with multi-specialty physician group practices; 3) IPA model, which contracts with Independent Practice Associations (IPA), which, in turn, contract with independent physicians who practice in their own offices; 4) network model, which contracts with two or more independent group practices and/or IPAs. The HMO can be sponsored by the government, medical schools, hospitals, employers, labor unions, consumer groups, insurance companies, and hospital medical plans.
Health Maintenance Organization. A network of doctors and hospitals that offers services. Except in an emergency, if you use doctors and hospitals that are not in your HMOâ€(tm)s network, no benefits are payable. You must select a Primary Care Physician to coordinate all your care.
Health Maintenance Organization. A health plan that provides care through a network of physicians and hospitals located in particular geographic or service areas. HMOs emphasize prevention and early detections. Your eligibility to enroll in an HMO is determined by where you live or, in some plans, where you work. Some HMOs have agreements with providers in other service areas for non-emergency care if you travel and are away from home for extended periods. The HMO pays for all covered services as long as you use the doctors and providers in the HMO network. You may have to pay something when you get care, for example, a $10 copayment per office visit. Most HMOs ask you to choose a doctor or clinic to be your primary care provider, or PCP. Your PCP takes care of most of your medical needs. In many HMOs, you must get permission or a referral from your PCP in order to see other providers in the network. Care received from a non-network provider, other than emergency care, is not covered.
health maintenance organization. an organization that provides comprehensive medical care to a voluntarily enrolled consumer population in return for a fixed, prepaid amount of money
Health Maintenance Organization. An organization providing comprehensive health care services for a fixed, prepaid premium. Most HMOs require that you use physicians within their network. Oftentimes, you are required to choose your primary care physician who monitors your health and directs most courses of your treatment. HMOs use managed care techniques.
Health Maintenance Organization. A health care plan that manages and administers coverage of comprehensive health services. A personal care physician provides your care and refers you to specialists when necessary.
An organization that provides prepaid subscribers with a range of healthcare services from a limited group of medical professionals and facilities.
Health Maintenance Organization. Typically, pays a doctor a flat amount each month based on how many patients from the HMO are assigned to him/her. Staff HMO: the practitioner is employed by the HMO. Group Model: the HMO contracts with a practicing group of physicians to send HMO patients to them IPA: a group of doctors who are in separate practices who band together for negotiating with an insurer.
Health Maintenance Organization. There are various types of HMOs. In staff-model HMOs, such as Kaiser Permanente, you typically choose from the care providers they have on staff. In other HMOs, you choose your care providers from listings of independent care providers with whom the health plan has negotiated rates.
Health Maintenance Organization. An HMO is a health plan to which you pay a fixed premium for an assortment of medical services, usually including primary and preventive care. The primary purpose of an HMO is to coordinate care so as to eliminate unnecessary care and costs. HMOs typically have co-pays rather than cost shares.
Health Maintenance Organization. A federal act that protects people who change jobs, are self-employed or who have pre-existing medical conditions. HIPAA standardizes an approach to the continuation of healthcare benefits for individuals and members of small group health plans and establishes parity between the benefits extended to these individuals and those benefits offered to employees in large group plans. The act also contains provisions designed to ensure that prospective or current enrollees in a group health plan are not discriminated against based on health status.
HEALTH MAINTENANCE ORGANIZATION. Managed care health insurance with an emphasis is on preventive care. The "subscribers" can attend classes on topics such as how to stop smoking, weight loss, etc.
Health maintenance organization. An entity with four essential attributes: an organized system for providing health care in a geographic area, which entity accepts the responsibility to provide or otherwise assure the delivery of an agreed upon set of basic and supplemental health maintenance and treatment services to a voluntary enrolled group of persons, and for which services the HMO is reimbursed through a predetermined, fixed, periodic prepayment made by or on behalf of the amounts of actual services provided (from the report of the Committee on Interstate and Foreign Commerce on the HMO Act of 1973, P.L. 93-222, in which the term is legally defined, section 1301 of the PHS Act).
Health plans that provide comprehensive health care services to members for a fixed fee. Members are generally limited to using doctors and hospitals designated by the HMO.
Health Maintenance Organization. Organization licensed by the state to provide comprehensive health services to enrolled subscribers and their dependents.
Health maintenance organization. A health care financing and delivery system that provides comprehensive health care services for subscribing members in a particular geographic area in return for a fixed, prepaid fee.
Health maintenance organization. The term used to describe payer organizations that form a network of physicians and hospitals, and contract with them for lower rates on patient care. HMOs focus on preventive care and maintaining health, in addition to treating illnesses. Primary care physicians (PCPs) are generally used as gatekeepers to direct patients to appropriate, cost-effective care. Obtaining care without a PCP's referral, or obtaining care from a non-network provider, usually results in nonpayment for services by the HMO.
Health Maintenance Organization. an organization that provides health care through a network of doctors, hospitals and other medical professionals. HMO members must use the network to be covered for that care. HMOs are a part of Managed Care (see definition below).
Health Maintenance Organization. An organization that provides, or arranges coverage of health care services for a group of patients. Employer-based HMO coverage is generally paid on a capitated basis for a fixed premium.
A health maintenance organization (HMO) is an insurance plan that requires a person to get care from providers who are part of the HMOs network. Usually, a primary care provider coordinates care and controls access to specialists. Most HMOs offer a point-of-service (POS) option for additional fees.
HMOs offer a comprehensive range of services at no cost or for a nominal fee to members who pay an annual membership fee.
health maintenance organization. A health care plan that combines the financing and delivery of health care to provide comprehensive health care services for subscribing members in a particular geographic area in exchange for a prepaid fee.
Health Maintenance Organization. A Nixon-administrationname that has stuck for capitated prepaid health plans. They may begroup models or hospital-based models, or individual physicianscontracting.
Health Maintenance Organization. An organization that provides health care in return for pre-set monthly payments. Most HMOs provide care through a network of doctors, hospitals and other medical professionals that their members must use in order to be covered for that care.
The abbreviation for a health maintenance organization, a kind of health insurance plan. People who join HMO plans agree to use medical providers who work for or contract with the HMO. HMOs generally do not require the payment of deductible amounts, but they often do require the payment of a small fee, called a co-payment, for services like doctor visits or prescriptions.
Health Maintenance Organization. A term applying to an organization or set of related entities organized for the purpose of providing service benefits to an enrolled population, for a predetermined fixed periodic amount to be paid by the purchaser (e.g., government, employer, individual).
A Health Maintenance Organization is a health plan that receives a discount from hospitals, physicians, and other providers based upon the volume of patients each provides. The HMO's members receive comprehensive preventative, hospital, and medical care from specific medical providers who have agreed upon pre-set rates. Members select a Primary Care Physician or medical group from the HMO's list of affiliated doctors and generally have no deductibles or claim forms. Members make a small co-payment, usually between $3 and $20. Some HMO's have capitated contracts with providers and some pay providers on a single discounted fee-for-service basis.
healthcare management organization
Health Maintenance Organization. Prepaid group health insurance plan that entitles members to services of participating physicians, hospitals and clinics. Emphasis is on preventative medicine, and members must use contracted health-care providers.
Health Maintenance Organization. An organization that provides health care for a geographic area and accepts responsibility for delivering an agreed set of health maintenance and treatment services to a voluntarily enrolled group. An HMO collects a predetermined periodic payment paid in advance on behalf of each individual enrolled.
Health Maintenance Organization. A type of Health Benefit Plan under which the Members are required to receive care through a specific group of participating doctors and hospitals in order to receive Benefits.
Prepaid health plans. You pay a monthly premium and the HMO covers your doctors' visits, hospital stays, emergency care, surgery, checkups, lab tests, x-rays, and therapy. You must use the doctors and hospitals designated by the HMO.
HEALTH MAINTENANCE ORGANIZATION. A health plan that arranges or provides health care services to consumers in exchange for a fixed, prepaid monthly premium. HMOs usually use designated doctors or hospitals, and assume the costs of medical treatments that are higher than the consumers' basic fees and co-payments.
Health Maintenance Organization. A pre-paid medical group practice plan that provides a comprehensive predetermined medical care benefit package in a specified geographical location.
Health Maintenance Organization. also referred to as managed care plans. The HMOs were designed to control spiraling health care costs while maintaining quality care and services. Most HMOs prepay providers for an enrolled group of members, assign members to primary care physicians, and arrange comprehensive benefits through a more limited provider panel. Copayments are often used in the HMO model as the cost- sharing method for the patient.
Health Maintenance Organization. A type of managed care plan where a beneficiary's "primary care physician" coordinates and controls access to care. The beneficiary must receive medical services from an approved network of doctors, hospitals, skilled nursing facilities, and other providers included in the plan.
Health Maintenance Organization. An organized system for providing comprehensive prepaid health care. HMOs provide care in a defined geographic area; provide or ensure delivery of an agreed-upon set of basic and supplemental health maintenance and treatment services; provide care to a voluntarily enrolled group of persons; require their enrollees to use the services of designated providers; and receive a predetermined, fixed, periodic prepayment made by or on behalf of the member. HMOs are licensed and reviewed by government agencies such as Agency for Health Care Administration (AHCA) to ensure compliance with state and/or federal regulations.
Health Maintenance Organization. A type of Health Benefit Plan under which the Members receive all medical services through a specific group of Participating Providers.
Health Maintenance Organization. A company that offers health plans that provide medical care from an approved network of providers, at a set fee per visit. You must see a provider within the network, or the HMO may not pay for the service.
Health Maintenance Organization. A type of service provider that arranges for both health care services and payment for those services. Requires members to pay a pre-set monthly fee covering a broad range of services rather than payment for individual services. Members must use medical practitioners and facilities approved by the HMO, usually at a location the HMO owns and operates and using medical personnel employed by the HMO. HMOs may contract with Medicare to offer Medicare beneficiaries all services covered by fee-for-service Medicare. When a Medicare beneficiary joins an HMO, he or she must usually “sign over” their Medicare benefits to that HMO.
Health maintenance organization- A group of doctors, hospitals, and other health care providers who agree to give health care to beneficiaries for a set amount of money every month. In an HMO, you usually must get all your care from the providers that are part of the plan.
Health Maintenance Organization. Refer to HMO for definition. See: Managed Care
Health Maintenance Organization. An organization offering a health plan that provides comprehensive medical services directly to eligible enrolled clients in exchange for a prepaid monthly premium. See: Managed Care
HEALTH MAINTENANCE ORGANIZATION. A health care plan that coordinates and offers medical services through a group of contracted individual doctors (or groups of doctors), area hospitals, and other medical service providers. Normally requires selection of a Primary Care Physician (PCP) or a Primary Medical Group (PMG).
(Health Maintenance Organization): A health care delivery system that provides comprehensive services for subscribing members in a particular geographic area. Most HMO care is provided through a managed network made up of doctors, hospitals and other medical professionals selected by the HMO. HMO enrollees are required to obtain care from this network of providers in order for their care to be covered, except incases of emergency. All the care that members may need is paid for by the single monthly fee, plus nominal copayments. Generally, there are five types of HMOs: Staff Model, Group Model, IPA, Network Model and Mixed Model.
An organization that provides a wide range of comprehensive health care services through a designated group, or network of doctors, hospitals, laboratories and other providers. To receive benefits, the member must see the doctor he selects as his primary care physician first for care or a referral, except in the case of an emergency. The choice of doctors is restricted to those in the network.
Health Maintenance Organization. Prepaid health plans that provide a range of services in return for fixed monthly premiums or other payment methods. Virtually any organization can sponsor an HMO, including the government, medical schools, hospitals, employers, labor unions, and insurance companies.
Health maintenance organization. A type of prepaid health care plan consisting of physicians, hospitals, and other medical service providers that offers a range of health care services for a fixed fee paid in advance. Federal law requires employers with 25 or more employees to offer HMOs as an alternative to traditional health insurance plans in local areas where HMOs are available. HMOs may contract with Medicare to offer Medicare beneficiaries all services covered by fee-for-service Medicare.
Health Maintenance Organization. An organization consisting of hospitals, physicians, and other health care personnel who have joined together in an central facility to provide necessary health care services to its subscribers.
Health maintenance organization. A type of health care plan that offers patients medical coverage with low or no copayments for visits to doctors and hospitals that belong to that HMO network.
Health Maintenance Organization. A managed care plan which stresses preventative care and offers the HMO the same premium whether or not a patient needs help. This encourages patients to keep up with medical problems instead of letting unknowingly potentially serious conditions go too far.
Health care delivery system that typically uses contracted primary care physicians to coordinate all health care for enrolled members. HMOs require you to select a primary care physician (PCP). The PCP coordinates your care and refers you to specialists and hospitals. Covered services are usually paid in full after you pay any required copay. No claim forms are required. See definition of the Kaiser Permanente HMO below for a non-PCP HMO model of health care.
A health benefits program that usually has the lowest out-of-pocket costs. HMOs require that the member select a primary care physician, generally a family practitioner, internist or pediatrician, who is part of the plan's network. There are generally no deductibles, small co-payments and no claims to file. A referral is required from the primary care physician to see any specialist in its network except an OB/GYN.
HEALTH MAINTENANCE ORGANIZATION. An organization engaged in providing managed care and assuming the risk for health related benefits.
A health plan that offers an organized system of health care to assure the delivery of an agreed upon set of comprehensive health maintenance and treatment services, ranging from vaccinations to cardiac surgery, in exchange for a set annual fee. HMO members have very few out-of-pocket expenses.
Short for Health Maintenance Organization. An HMO is a prepaid medical service plan that provides medical services to plan members. Medical providers contract with the HMO to provide medical services to plan members. Plan members may only receive medical care from contracted providers.
Health Maintenance Organization. An organization that provides comprehensive and preventive health care services for a fixed periodic payment from the covered person (or the covered person's employer) generally through owned (or contracted) facilities and a salaried medical staff.
Health Maintenance Organization. HMOâ€(tm)s provide health care services for a fixed fee and a low co-payment for services. You are covered only for treatment approved by the HMO and you must use HMO physicians and facilities (refer to page 13).
Health Maintenance Organization. An organization that provides a wide range of comprehensive health care services for a specified group of enrollees for a fixed, prepaid premium. There are several models of HMOs: Group Model, Individual Practice Association (IPA), Staff Model and Network Model.
A health maintenance organization (HMO) is an entity that contracts on a prepaid, capitated risk basis to provide comprehensive health services to beneficiaries.
Health Maintenance Organization. An HMO is a prepaid medical service plan which provides services to plan members. Medical providers contract with the HMO to provide medical services to plan members. Members must use contracted providers. The emphasis is on preventive medicine, and it is an alternative to employee benefit plans. Employers of more than 25 persons are required to offer the alternative of HMO to employees, but not if the cost exceeds that of present employee benefit plans.
Health Maintenance Organization – an organization that maintains a system that provides health care in a geographic location. The HMO sets limits on the services performed by health care facilities. It is offered to a group of persons who may enroll voluntarily in the organization and who pre-pay for the service in regular intervals irregardless of the amount of actual services rendered.
Health Maintenance Organization. This form of health insurance combines a range of coverage in a group basis. Physicians and other healthcare providers offer medical services through an HMO for a flat monthly rate with no deductibles. Patient visits to HMO network physicians are covered by the plan. Additional medical services, such as referral to a specialist or prescriptions, must be approved by the HMO. Referrals to specialists are handled by a primary care physician within the HMO network.
Prepaid health plans for which a premium is due each month. The HMO covers your cost of care to see a doctor within their working network at pre-negotiated rates. You are required to choose a primary care physician who takes care of you and makes referrals to any specialists you may need. If you, as an HMO member, do not use the doctors, hospitals and clinics that do not participate in your plan's network, you may be required to pay the cost of those medical services.
The abbreviation for health maintenance organization, a benefit program in which you receive all or most treatment through the dental office where you are enrolled. The dentist receives a single monthly payment from the benefits carrier for each enrolled patient, no matter how many services that patient receives. DeltaCare, offered by Delta affiliate PMI Dental Health Plan, is a dental HMO program.
Health Maintenance Organization. A health plan that utilizes a designated group, or network of doctors, hospitals, labs and other providers to provide healthcare services to members. See health plan product descriptions. To receive benefits, the member must first see his/her Primary Care Physician for care or for a referral, except in the case of an emergency. The memberâ€(tm)s choice of providers is restricted to those in the network. Find an Optima Health participating provider.
Health Maintenance Organization. This is a type of insurance which is inexpensive but which limits medical care choices.
Health Maintenance Organization. A form of health insurance in which members prepay a premium for the HMO's health services. The HMO is the legal entity that assumes responsibility for health care services and for the cost of care. There are different models: staff, group, IPA, hybrid, network, and POS. The Staff Model HMO is an organization that employs physicians who are salaried. The Group Model is similar except the physicians are organized as a group which contracts with the HMO. A Network Model HMO consists of a network of physicians who work in their offices and may not work exclusively for the HMO.
Health Maintenance Organization. An organization that delivers and manages health services under a risk-based arrangement. The HMO usually receives a monthly premium or capitation payment for each person enrolled which is based on a projection of what the typical patient will cost.
Health Maintenance Organization. An organization to which Medicare pays a pre-determined annual fee for each Medicare eligible person who enrolls. The HMO then provides the older person with any necessary medically authorized health care during the year.
Health Maintenance Organization. An insurance plan that pays for preventive and other medical services provided by a specific group of participating providers.
health maintenance organization. A health care system that assumes or shares both the financial risks and the delivery risks associated with providing comprehensive medical services to a voluntarily enrolled population in a particular geographic area, usually in return for a fixed, prepaid fee.
See health maintenance organization.
Health Maintenance Organization. Offers comprehensive health benefits for members who are enrolled on a group basis and who pay a fixed premium in advance for services provided by participating physicians and hospitals.
Health Maintenance Organization. A medical plan providing comprehensive medical benefits, including preventive care, when you agree to use a select group of network providers. Generally, all care is directed by your chosen Primary Care Physician (PCP) who will refer you to a specialist if medically appropriate.
Health Maintenance Organization. an entity that provides, offers or arranges for coverage of health services needed by plan members for a fixed, prepaid amount of money.
Health Maintenance Organization. A prepaid health plan that provides comprehensive benefits using certain health care professionals, at times in specified locations, generally within certain geographic areas.
Health Maintenance Organization. an organization that provides a comprehensive range of health services including hospitalization, preventive care, and diagnosis. HMOs require members to use specific health care services (doctors, hospitals, etc.) in the HMO's "network." The HMO will pay less or nothing if members go outside the network.
Health maintenance organization, providing people with financial alternatives to fee-for-service health care.
HEALTH MAINTENANCE ORGANIZATION. Organization that has management responsibility for providing comprehensive health care services on a prepayment basis to voluntarily enrolled persons within a designated population.
Health Maintenance Organization. A managed care plan that provides health care to plan members on a pre-paid basis. In most HMOs, you must get all your care from the doctors and hospitals that are part of the plan's network. Usually a primary care doctor coordinates all of your care and refers you to specialists.
or Health Maintenance Organization A medical insurance provider under which services are obtained via a network of participating doctors and facilities. Usually, you receive no benefits if you obtain services from doctors or facilities outside their network. See a comparison between HMOs and PPOs.
Health Maintenance Organization. An organized health plan that provides health care to enrolled individuals and families in a particular geographic area by member physicians – in a group practice or independently contracted – with limited referral to outside specialists. Prevention is stressed to avoid people getting sick and requiring more costly hospitalization.
Health Maintenance Organization. One-stop healthcare organization which provides for all medical needs and makes referrals for any specialized care required but not available within the main structure of the organization. Most HMO's consists of a large group of healthcare professionals who can provide services in a variety of general areas. The overall operation is managed like a business and the emphasis is on preventive healthcare measures.
Health Maintenance Organization. An organization of health care providers that provides services for a specified group at a fixed cost.
Health Maintenance Organization. A prepaid plan (not insurance) that offers a variety of health care services for a fixed monthly fee.
health maintenance organization. Prepaid health plans in which you pay a monthly premium and the HMO covers your necessary medical treatment. You must choose a primary care physician from within the network to coordinate all of your care. All specialty referrals need to be authorized by your primary care physician.
Health Maintenance Organization. An HMO is a type of health plan in which a member of the plan pays for the care on a copayment basis. As long as the member complies with the provisions of the plan (generally one must first visit a predesignated doctor or clinic in order to obtain care at the discretion of the HMO), there are no other charges for the health care services.
Health Maintenance Organization: People enrolled in this type of plan must choose a primary care physician (PCP) from a list of participating doctors. For any non-emergency hospital or specialty care, enrollees must get a referral from their primary care physicians.
A form of health insurance combining a range of coverages in a group basis. A group of doctors and other medical professionals offer care through the HMO for a flat monthly rate with no deductibles. However, only visits to professionals within the HMO network are covered by the policy. All visits, prescriptions and other care must be cleared by the HMO in order to be covered. A primary physician within the HMO handles referrals.
Health Maintenance Organization. HMOs are the oldest form of managed care plan. HMOs offer members a range of health benefits, including preventive care, for a set monthly fee. There are many kinds of HMOs. If doctors are employees of the health plan and you visit them at central medical offices or clinics, it is a staff or group model HMO. Other HMOs contract with physician groups or individual doctors who have private offices. These are called individual practice associations (IPAs) or networks. HMOs will give you a list of doctors from which to choose a primary care doctor. This doctor coordinates your care, which means that generally you must contact him or her to be referred to a specialist. With some HMOs, you will pay nothing when you visit doctors. With other HMOs there may be a co-payment, like $5 or $10, for various services. If you belong to an HMO, the plan only covers the cost of charges for doctors in that HMO. If you go outside the HMO, you will pay the bill. This is not the case with point-of-service plans.
A Health Maintenance Organization (HMO) is a state-designated insurance entity authorized to sell commercial, Medicare or Medicaid health insurance in certain counties. HMO's are known for emphasizing preventative medicine, and paying their doctors and hospitals a fixed dollar capitation for each member assigned to a provider group. An HMO is typically separated from a PPO or Indemnity Health Insurance by two major things: A primary care physician referral is required to access a specialist's care The primary care physician is capitated.
Health maintenance organization. Prepaid medical plan in which members agree to use a specific network of providers.
An organization that provides a wide range of comprehensive health care services through a designated group, or network of doctors, hospitals, labs and other providers. To receive benefits, you must first see the Primary Care Physician you selected for care or a referral, except in the case of an emergency. Your choice of doctors is restricted to those in the network. If you are an HMO member and you do not use the doctors, hospitals and clinics that participate in your plan's network, you will usually bear the cost of those medical services.
Health Maintenance Organization. A health plan, either for-profit or not-for-profit, that provides comprehensive medical services to its members for a fixed, prepaid premium. Members must use participating providers and are enrolled for a fixed period of time.
Health maintenance organization. A "prepaid" or "capitated" insurance plan in which individuals or their employers pay a fixed monthly fee for services, rather than a separate charge for each visit or service.
Health maintenance organisation. A prepaid, organised delivery system where the organisation assumes financial risk for the care provided to its enrolled members. Financial risk may be transferred to clinicians through capitation and other financial incentives
Health Maintenance Organization. A type of health care program in which enrollees receive benefits when they obtain services that are provided or authorized by selected providers, usually with a primary care physician "gatekeeper." In general, enrollees do not receive coverage for the services of providers who are not in the HMO network, except for emergency services.
Health Maintenance Organization. An HMO (Health Maintenance Organization) is a managed care program. Most HMO's require each family member to select a Primary Care Physician from an approved list provided by the HMO. This Primary Care Physician will then direct all of your medical treatment including referring you to a specialist. This specialist is usually a member of the HMO you are insured with. Failure to see your selected Primary Care Physician first (unless in an emergency situation) can result in sharply reduced benefits or no benefit at all. As a general rule, HMO's provide the most comprehensive medical care; such as routine office visits, physical exams, well-baby care and immunizations. HMO's also feature low office visit co-payments and usually do not require the filing of claim forms.
Health Maintenance Organization. Health insurance plan that entitles individual members to an array of medical services provided by participating physicians, hospitals, and clinics.
Health Maintenance Organization. A group health care plan that provides a full range of health care services to its members. Members of an HMO must typically receive all of their medical care form health care providers in the HMO network, coordinated by a primary care physician. All visits, prescriptions and other care must be cleared by the HMO in order to be covered. A primary physician within the HMO handles referrals. It is similar to an HCO, but care is paid for in advance in the form of a scheduled fee, rather than as care is incurred.
Health Maintenance Organization. Prepaid health plans in which you pay a monthly premium and the HMO covers your doctors' visits, hospital stays, emergency care, surgery, preventive care, checkups, lab tests, X-rays, and therapy. You must choose a primary care physician who coordinates all of your care and makes referrals to any specialists you might need. In an HMO, you must use the doctors, hospitals and clinics that participate in your plan's network.
Health Maintenance Organization — a type of health insurance provider
HEALTH MAINTENANCE ORGANIZATION. A legal corporation that offers health insurance and medical care. HMOs provide a wide range of comprehensive health-care services for a specified group at a fixed, periodic rate. They can be sponsored by the government, medical schools, hospitals, employers, labor unions, consumer groups, insurance companies and hospital-medical plans.
Health maintenance organization. An entity that provides a wide range of health services for a fixed, prepaid premium. The HMO may provide all services or contract with other sources for additional services.
Health Maintenance Organization. The HMO plan is administered by HMO Blue (Blue Cross Blue Shield). The member must choose a Primary Care Physician from a list of network doctors in order to receive benefits. A referral is required to see a network specialist and for network hospitals. A co-payment is due at the time covered services are rendered.
Health Maintenance Organization. An organization that, for a prepaid fee, provides a comprehensive range of health maintenance and treatment services (including hospitalization, preventive care, diagnosis, and nursing).
Health Maintenance Organization. a type of managed care plan in which the member is required to select a primary care physician to provide and coordinate all covered medical care, including referrals for specialist services.
An HMO is an organization of healthcare personnel and facilities that provides a comprehensive range of health services to enrolled consumers/members. Healthcare providers receive a fixed sum of money paid in advance for a specified period of time for the services they provide. These health services include a wide variety of medical treatments and consultations, inpatient and outpatient hospitalization, home health service, ambulance service, and sometimes dental and pharmacy services. HMO stands for Health Maintenance Organization.
Health Maintenance Organization. See Part II, 45 CFR 160.103.
Health Maintenance Organization. A health care insurance plan that provides participants with comprehensive coverage of health care services performed by a selected network of health care providers for a fixed monthly premium. Coverage is available in a defined geographic area (called the service area) to participants who agree to obtain services from network providers. HMOs are unique because they coordinate the financing of health care with the delivery of health care. HMOs emphasize prevention and early detection of illness.
SSee health maintenance organization.
HEALTH MAINTENANCE ORGANIZATION. An organization that provides, offers or arranges for a wide range of covered health care services for a specified group of enrollees for a fixed, periodic prepayment. Models include: group model, individual practice association, network model, mixed model and staff model. Under the Federal HMO Act, an entity must have three characteristics to call itself an HMO: An organized system for providing health care or otherwise assuring health care delivery in a geographic area. An agreed upon set of basic and supplemental health maintenance and treatment services. A voluntarily enrolled group of people.
Health maintenance organization. Managed care plan that provides services for a fixed period on a prepaid basis.
A health insurance plan where you select a primary care physician who is responsible for the overall management of your medical care. A referral by your PCP is required to see a specialist. Out-of-network benefits are not available.
Health Maintenance Organization. a private medical service organization providing hospitalization, surgery, and care by physicians through prepaid medical care plans Œ'NˆÛŽ‹@\iŠó–]‚µ‚ĉÁ“ü‚µ‚1/2ŒÂlA‰Æ‘°‚ɑ΂µ‚ăƒ“ƒo[‚̈ãŽt‚ª•ïŠ‡“I‚Ȉã—Âðs‚¤‘gDj
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