HMO (Health Maintenance Organization)
An HMO keeps costs low by requiring you to use an in-network primary care doctor who coordinates all care and refers you to specialists.
- Brand
- Plan type
- Category
- Health Insurance Plan Types
- Released
- Price
- Not published
- VersusAnything Score
- 88/100
Key features
- Lowest premiums of the main types
- Predictable copays
- Primary doctor coordinates care
Best for people who want low premiums and are happy to stay within one network.
HMO plan specifications
| Network flexibility | In-network only (except emergencies) |
|---|---|
| Referral needed for specialists | Yes, from your primary care physician |
| Out-of-network coverage | No, except emergencies |
| Premium level (1 = lowest) | 1 |
| Typical deductible | Low or none |
| HSA eligible | Only if paired with a high deductible |
| Best for | Budget-conscious people who rarely need out-of-network care |
| Main drawback | No cover outside the network; referrals slow down specialist visits |
Score breakdown
- Overall (100%)
Scored against every health plan in our database using the health insurance plan types weighting.
Pros and cons
Pros
- Lowest premiums of the main types
- Predictable copays
- Primary doctor coordinates care
- Strong overall score (88/100 within health insurance plan types)
Cons
- No weak scoring group in its category
Compare HMO plan against
Alternatives to HMO plan
Sources
- HMO plan: Plan type official (manufacturer)
Specifications last verified: 2026-10-01. Prices are launch or official list prices in US dollars unless stated. See our sources and data policy.