What is the definition of a Health Maintenance Organization (HMO)?

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Multiple Choice

What is the definition of a Health Maintenance Organization (HMO)?

Health Maintenance Organization plans manage care by restricting you to in-network providers, requiring a primary care physician who acts as the gatekeeper for referrals, and emphasizing coordinated, preventive services to keep people healthy and control costs. This setup—network limits, a PCP coordinating care, and a focus on preventive care—defines how HMOs operate and differentiates them from other plan types. The other descriptions describe different models: unlimited out-of-network coverage points to PPO or indemnity plans, no PCP requirement doesn’t fit the gatekeeper structure, and an urgent-care-only focus doesn’t reflect the comprehensive, preventive approach of an HMO.

Health Maintenance Organization plans manage care by restricting you to in-network providers, requiring a primary care physician who acts as the gatekeeper for referrals, and emphasizing coordinated, preventive services to keep people healthy and control costs. This setup—network limits, a PCP coordinating care, and a focus on preventive care—defines how HMOs operate and differentiates them from other plan types. The other descriptions describe different models: unlimited out-of-network coverage points to PPO or indemnity plans, no PCP requirement doesn’t fit the gatekeeper structure, and an urgent-care-only focus doesn’t reflect the comprehensive, preventive approach of an HMO.

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