Health Maintenance Organization (HMO)

HMOs stress regular member checkups, immunizations and early detection of illnesses with enhanced coverage for these services. HMOs traditionally have used "gatekeepers" a primary care physician participating in the plan who approves referrals to surgeons, dermatologists and other specialists. Recently, however, some HMOs are removing some or all restrictions on members seeking referrals. HMOs usually do not require claim forms and do not require deductibles and have low co-payments when members receive care within a network.