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HMO stands for Health Maintenance Organization. It’s a type of health plan that gives you access to a network of doctors and hospitals, often called providers. This group of health care professionals work together to provide you with a full range of covered health care services. HMO is different from PPO (Preferred Provider Organization) insurance in a few ways.
When you sign up for an HMO plan, you first choose to select or be assigned a primary care physician (PCP) from a network of doctors.
HMO plans:
An HMO is a good choice for a lot of reasons. Making sure you follow HMO rules will make sure you get the most of benefits:
Whenever you have questions about your HMO plan, use our handy resources. Sign up for Blue Access for MembersSM (BAM) or call the customer service number listed on your member ID card. BAM lets you keep track of your balances, claims status, benefits, coverage details and more.
Originally published 10/2/2018; Revised 2021, 2022