MODULE 2

Lesson 1 - Plans

HMO – Health Maintenance Organization 

  • In-Network coverage ONLY
  • PROS
    • Out-Of-Network for emergency / urgent care situations
    • USUALLY
      • Lower copays
      • Lower / No deductibles
        • Medical and RX
      • Higher allowance for benefits
        • Dental, Vision, Hearing, OTC
  • CONS
    • ONLY allowed to see Doctors 
    • Smaller / Limited Doctor Network
    • MUST
      • Have a Primary Care Doctor assigned to the plan
      • Have a Primary Care Doctor refer them to a specialist
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