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HMO plans: understanding your coverage

FreeChapter 23:564 key terms

An HMO keeps premiums lower by coordinating your care through a primary care doctor and a defined network. This lesson explains referrals, what's covered out-of-network (usually only emergencies), and who an HMO fits best.

What you'll learn

  • How an HMO uses a primary care physician to coordinate care
  • When you need a referral to see a specialist
  • What an HMO does and doesn't cover out-of-network

Key takeaway: An HMO trades flexibility for lower cost — you stay in-network and route care through your PCP.

Networks & plan types

8 lessons

In-network vs out-of-network, how HMO, PPO, EPO, and HDHP plans decide what you'll pay, and how HSAs and FSAs help you save.

  1. 1In-network vs out-of-network3:37
  2. 2HMO plans: understanding your coverage▶ Now playing3:56
  3. 3High Deductible Health Plans (HDHP)4:00
  4. 4PPO plans: flexibility at a higher cost3:45
  5. 5EPO plans: network-only, no referrals3:30
  6. 6FSA & HSA: an overview4:10
  7. 7HMO vs PPO: which fits you4:20
  8. 8HSA vs FSA: a detailed comparison4:15
Next lesson
High Deductible Health Plans (HDHP)
Next: High Deductible Health Plans (HDHP) →