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September 25, 2016
HMO stands for Health Maintenance Organization. It’s a type of health plan that is designed to keep costs low and predictable. An HMO health plan may be a good choice for you because:
An HMO health plan is designed so that you have care personalized to you. Your care is coordinated by one doctor who knows you — your health history, current issues and medication, lifestyle and how your family’s health history may affect your health.
When you first sign up for an HMO health plan, you choose, or are assigned, a primary care physician (PCP) who’s part of a medical group/independent practice association (MG/IPA).
Each person on your plan can pick their own PCP. PCPs typically focus on general internal medicine or family medicine. Women and girls can choose an OB/GYN or a WPHCP as their PCP. Older adults can choose a geriatric doctor. Children can have a pediatrician as their PCP.
Your PCP is your partner in keeping you healthy. Follow these guidelines to work with your PCP:
In addition, you will need a referral to visit a hospital for non-emergency services. You can search for participating hospitals and providers in Provider Finder to see who is covered in your network.
Of course! You can change your PCP or medical group/IPA at any time, except if you are hospitalized or in the 2nd or 3rd trimester of pregnancy.
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