How do HMO networks work?
If you have a health insurance plan that is administered by a health maintenance organization, then the doctors and hospitals that accept your plan are all a part of the same tight network of providers. Many times this consists of a central hospital, outpatient surgery and diagnostic centers, specialists affiliated with the hospital, and general practitioners, such as pediatricians and obgyn doctors in satellite offices. You will have to choose a primary care provider that in many ways serves as a gatekeeper for the HMO. It is through your primary care physician that you will be able to get referrals to specialists and having diagnostic tests done. Most non emergency procedures must be pre-approved by the HMO through your primary care doctor in order for the insurance benefit to be paid. In most cases, the service must also be provided by a care provider within the HMO. In accidents and emergencies this is not the case, as in most states, insurance coverage is required to be the same i
