Six Factors to Help You Choose the Right HMO Plan in Wisconsin

  • September 13, 2016
  • |Quartz
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Get help choosing the right HMO plan in Madison, Wisconsin by considering these 6 factors.

Health Maintenance Organization (HMO) plans are a common type of health insurance in Wisconsin. Here are 6 factors to help you choose a HMO plan that may be right for you.

  1. Cost. HMO plans are offered in all metal levels, so chances are you’ll find a plan with a benefit and cost structure that is good for you. There are many different HMO plans and it is important to compare your options before selecting the plan that is right for you. The cheapest plan may not always be the best option for your unique health needs.

  2. Quality. Many health plans are rated by a national quality organization, the National Committee for Quality Assurance (NCQA). HMO plans are not required to be reviewed by NCQA. HMO plans that do work with NCQA tend to focus on quality. For example, Unity has consistently maintained an Excellent Accreditation status through NCQA since 2002.*

  3. Network. Make sure the HMO's network includes a primary care physician (PCP) you're comfortable with. Typically, an HMO plan requires you to pick a PCP that will act as your main health care provider. You will go to this doctor for all your health care services and if needed, they will help refer you to specialists. Also, check that the specialists, hospitals and clinics you prefer are included in the HMO's network. This is extra important with HMO plans, as the plan may not pay for out-of-network services.

  4. Wellness Programs. Many HMO plans have wellness programs, but these programs are not all the same. For example, Unity offers Fitness FirstSM & More that rewards you for living a healthy lifestyle. You can earn money by attending health and wellness classes, eating fresh produce, or managing your weight. Individuals or families may earn up to $200 per year just by participating.

  5. Health Management Programs. An HMO plan may offer health management programs for people with chronic health problems. Programs may focus on asthma, diabetes, high blood pressure or other long-term illnesses. Support may include personal health coaching, workshops, book clubs and phone counseling.

  6. Pregnancy & Childbirth Programs. HMO plans tend to focus on prevention. Many plans may offer programs to assist new mothers and mothers-to-be. Unity’s 9 Months & MoreSM program provides education, assistance and the opportunity to earn prizes just for attending scheduled doctor visits and administering shots (immunizations) for the baby.

Find a Unity HMO plan in Wisconsin that is right for you and get a quote today. Our HMO plans offer access to UW Health, including the American Family Children’s Hospital and UW Hospitals and Clinics (named Wisconsin’s #1 Hospital by US News & World Report).**

*Unity Health Plans’ Commercial HMO / POS plans are rated 4.5 out of 5 among NCQA’s Private Health Insurance Plan Ratings 2016 – 2017.

**The rankings are part of the 2016-2017 edition of the Best Hospitals guide by U.S. News & World Report.


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