Health Maintenance Organization (HMO)

With genuine care and unwavering commitment, we make your needs our top priority.

HMO Insurance Benefits

When choosing personal health insurance, you may have encountered HMO and PPO plans. Both can cover routine health care, checkups, and other medical needs, but they differ in key ways.

At Eleos, we’re dedicated to understanding your unique priorities and helping you find the plan that best fits your lifestyle.

The Eleos Difference

We lead with accountability so you can lead with confidence.

Our transparent and genuine approach to health insurance eliminates the confusion surrounding HMOs. We take the time to understand your lifestyle and educate you and your family on the best options for your needs.

Our commitment doesn’t end with the initial setup. We’re here for you, ready to answer questions and ensure you maximize your health coverage.

Because when you lead with values, value leads.

Connect with an HMO Specialist

Partner with a specialist who listens and get coverage tailored to your needs.

If you're uncertain about which plan is right for you, our health insurance specialists are ready to answer your questions and guide you to the best choice.

HMO Plan Essentials

The main difference between Health Maintenance Organization (HMO) plans and Preferred Provider Organization (PPO) plans is how you access care.

Unlike a PPO, which lets you visit any physician or specialist, an HMO requires you to select a Primary Care Physician (PCP) who coordinates your care. Your PCP acts as a gatekeeper, providing referrals for specialist visits when needed.

Here are some key differences between PPO and HMO plans:

  • Out-of-Pocket Costs: HMO plans generally offer lower out-of-pocket costs for regular care and lower monthly premiums compared to PPO plans.

  • Specialist Access: HMO plans require a referral from your PCP to see a specialist, whereas PPO plans allow you to see specialists without a referral.

  • Network Restrictions: HMO plans only cover services from in-network providers. If you need care while traveling or if your PCP is unavailable, you will have to pay for those services out-of-pocket.

  • Claim Filing: With HMO plans, you typically don’t need to file claims for in-network services. Many HMOs have direct payment arrangements with their network providers, which can reduce initial out-of-pocket costs for doctor visits.

While HMOs may present challenges for those with chronic conditions or frequent medical needs, their structure can offer cost savings and convenience for those with less frequent healthcare requirements.

Is an HMO Plan Right for Me?

Choosing between an HMO and a PPO plan involves considering several factors:

An HMO might be the right choice if you’re looking to save on monthly premiums and out-of-pocket costs and are comfortable with having a primary care physician coordinate your care and provide referrals for specialists. However, if you prefer greater flexibility in choosing providers and access to out-of-network care, a PPO may be more suitable.

Consider these factors to help decide:

  • How Frequently You Anticipate Needing to See a Doctor

  • How Often You Travel

  • Specialist Care Needs

  • Health Care Budget

Not Sure Where to Start?

A great plan begins with a conversation. Let's discuss your needs and find the right solution for you.