Definition

1. Noun:
   • Health Maintenance Organization: A type of health insurance plan that provides healthcare services through a network of specific hospitals, clinics, and doctors to its members for a fixed, prepaid fee.

Usage Examples

• Noun:
  • She switched to an HMO because it offered lower monthly premiums.
  • With this HMO, you must choose a primary care physician from their approved list.
  • The HMO denied coverage for the out-of-network specialist.

Advanced Usage

• "to be in an HMO": to be enrolled as a member of a Health Maintenance Organization.
  • Most employees at the company are in an HMO.
• "HMO model": refers to the structure and operational method of this type of managed care organization.
  • The HMO model emphasizes preventive care to reduce costs.

Variants and Related Words

• Health Maintenance Organization (HMO): The full, formal name.
• Managed Care: A broader term for healthcare systems that coordinate and control costs, of which an HMO is one type.
• PPO (Preferred Provider Organization): Another common type of health insurance plan with a different network and payment structure.

Synonyms

• Managed care plan: A plan that manages healthcare services and costs.
• Health plan: A general term for any insurance arrangement for health services.

Related Phrases

• HMO coverage: The scope of services and benefits provided by the HMO.
  • Check your HMO coverage for dental services.
• HMO member: A person enrolled in an HMO.
  • As an HMO member, you have access to the wellness program.

Notes on Meaning

• The term HMO specifically refers to a prepaid, closed-network model of healthcare. It is distinct from other models like PPOs or fee-for-service plans. The core idea is that members receive care from providers within the HMO's network, and a primary care physician often acts as a "gatekeeper" for referrals to specialists.

Noun

1. group insurance that entitles members to services of participating hospitals and clinics and physicians