HMO
Medical abbreviation · Health Insurance
| Stands for | Health maintenance organization |
|---|---|
| Categories | Medical |
HMO stands for Health maintenance organization, a health insurance abbreviation.
Managed care health plan that covers care only from its network of doctors and hospitals, except in emergencies, and usually requires members to choose a primary care physician who coordinates care and refers them to specialists. In exchange for these limits, HMOs typically have lower premiums and out-of-pocket costs.
Example: My HMO won't cover the dermatologist unless my PCP sends a referral first.
Usage notes
The Health Maintenance Organization Act of 1973 encouraged their growth with federal grants and a requirement that many larger employers offer an HMO option. Kaiser Permanente, with roots in the 1940s, is the best-known integrated HMO, employing its own physicians and owning hospitals. The ACA requires plans to cover emergency care at in-network cost sharing even at out-of-network hospitals. Pronounced as letters.
Related abbreviations
More health insurance abbreviations
- GFE – Good faith estimate
- HCC – Hierarchical condition category
- HCPCS – Healthcare Common Procedure Coding System
- HDHP – High-deductible health plan
- HEDIS – Healthcare Effectiveness Data and Information Set
- HIPAA – Health Insurance Portability and Accountability Act
- HRA – Health reimbursement arrangement
- HSA – Health savings account
- ICD – International Classification of Diseases
- ICD-10 – International Classification of Diseases, Tenth Revision
- ICD-10-CM – ICD-10 Clinical Modification
- ICD-10-PCS – ICD-10 Procedure Coding System
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This entry is for general education and is not medical advice. Abbreviation use varies between institutions; always confirm in context.