A health maintenance organization (“HMO”) typically requires its members to live or work in its service area to be eligible for coverage. HMOs emphasize integrated, preventive and wellness care in addition to treatment for illness and injury. Members or an HMO choose a Primary Care Physician (PCP) within the provider network. The PCP monitors the member’s healthcare needs and any existing conditions to help ensure they provide comprehensive and individualized care. The PCP is responsible for providing referrals to specialists.
This personal approach to healthcare allows an HMO to actively support its members’ health and provide members with a wide range of services to meet their needs.