HMO

A health plan that keeps costs down by sticking to its network and usually requiring a primary care doctor and referrals.

An HMO (Health Maintenance Organization) is a health plan that keeps premiums lower by concentrating your care within its network and coordinating it through a primary care doctor.

You typically pick a primary care physician who manages your care and provides referrals to see specialists, and outside-network care generally isn’t covered except in emergencies. In exchange for those guardrails, HMOs usually cost less and have simpler, more predictable copays.

It’s a good fit if you value lower costs and don’t mind staying in-network; if you want maximum freedom to see any provider, a PPO may suit you better.

This is a friendly general explanation, not legal or policy language. Exact coverage depends on your policy, carrier, and state. 🤝

Written and reviewed by the We Insure Things team — licensed independent insurance agents. Last reviewed July 23, 2026. Questions? Ask a licensed agent.