What is an open access Health Maintenance Organization (HMO) and how does it work?
An open access Health Maintenance Organization (HMO) provides health care services to enrolled members through a panel of HMO providers. When you enroll in an open access HMO, your plan may or may not ask you to select a participating PCP for each enrolled family member. If you are asked to select a PCP, you may select any participating PCP from your HMO’s provider directory. With an open access HMO, you may see any provider in the HMO’s panel without getting a referral. With an HMO plan, you generally pay a fixed amount each time you receive care. Coinsurance typically does not apply with an HMO Except in an emergency as defined by the plan, or with previous approval through the plan’s authorization procedures, only services provided by or referred by an HMO panel provider will be covered under an HMO.
