Group health insurance coverage is available in a PPO or HMO plan. A PPO allows employees to use the plan to go to the doctor of their choice whereas an HMO has specific requirements for use. Many employers what to know how to handle HMO plans.
The experts at iSure Insurance states that HMO insurance requires the use of a primary care doctor referral for additional care beyond what they provide. If a patient needs physical therapy, medical equipment or to see a specialist, the PCP must usually provide a referral in order for the insurance to provide coverage. While fewer unnecessary services occur, patients must go through several hoops to receive specific care.
An HMO plan is typically more economical than a PPO plan. Some plans do not even have a deductible. These plans come with lower-cost premiums and small copayments.
The list of in-network providers is robust in most areas. This list includes radiology, lab work, and therapy. However, going out of the network puts the burden of payment on the patient.
Understanding how to handle HMO plans can help your business decide if it is right for your employees. There are both benefits and drawbacks to choosing this type of health insurance. An insurance quote can help you determine which is the right option for your business.