Health Maintenance Organization (HMO) plans are a common type of health insurance in Wisconsin. Here are 6 factors to help you choose an HMO plan that may be right for you.
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.
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.
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.
HMO plans tend to focus on prevention. Many plans may offer programs to assist new mothers and mothers-to-be. Some programs provide education, assistance and the opportunity to earn prizes just for attending scheduled doctor visits and administering shots (immunizations) for the baby.
Find a Quartz 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.