Legal Definitions - health-maintenance organization

A health-maintenance organization, also known as an HMO, is a group of healthcare providers who offer medical services to members of a group health-insurance plan. HMOs are designed to provide affordable healthcare to individuals and families by offering a network of healthcare providers who have agreed to provide services at a reduced cost.

• John is a member of an HMO and can only receive medical care from healthcare providers within the HMO's network. This means that he cannot see a doctor outside of the network unless it is an emergency.
• Sarah's employer offers an HMO as part of their employee benefits package. Sarah can choose to enroll in the HMO and receive medical care from the providers within the network.

These examples illustrate how HMOs work by providing a network of healthcare providers who offer medical services to members of the plan. Members are typically required to choose a primary care physician within the network who will coordinate their medical care and refer them to specialists within the network when necessary. HMOs are a popular choice for individuals and families who want affordable healthcare coverage.