Group Health Insurance
HMO Insurance Plan
Pennsylvania Business
Preventive care emphasis
An HMO group health
insurance plan helps your
Pennsylvania small
business control health
care costs through a
closely managed plan with
an emphasis on
preventive care. Each
employee selects a
Primary Care Physician
from a network of
providers. The Primary
Care Physician can
coordinate the total care of
the employee to help
ensure appropriate care is
received. An employee
may also seek care from
any provider in the
network without a Primary
Care Physician referral,
subject to a higher out-of
pocket expense.
Subscribers to an HMO
receive medical services
from participating
physicians, clinics and
hospitals. An employee
chooses a primary care
physician from a list of
participating doctors. That
doctor is used for typical
circumstances such as
annual exams and usual
health issues. If the
employee needs to see a
specialist, be hospitalized,
or have lab or X ray work,
their doctor will refer them
to a provider or facility
within the HMO system.
Your employees doctor
must give authorization
for those services to be
covered by your HMO. In
other words, an employee
must see HMO approved
physicians and use HMO
approved facilities or pay
the entire cost of the visit
themselves.
Similar to Point-of
Service (POS) and
PPO's, HMO's have
made arrangements for
lower fees with a network
of health care providers
and give their
policyholders a financial
incentive to stay within
that network.
Primary care physician
coordinates the total care
of the employee
An employee may have to
pay some portion of the
cost (co-payment) for
each office or hospital
visit, such as $30 per
doctor visit, regardless of
what the services cost.
Also, some services such
as emergency room,
mental health and
chemical dependency
services, may carry
additional costs in a
Pennsylvania HMO health
insurance plan.
HMO Coverage Explained
Click on the link below to
fill out a Pennsylvania
Group Health Insurance
quote form.
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PA Group
Insurance
HMO
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Insurance