What in the World is an HMO?
Blue Cross of California HMO
Blue Cross Blue Shield of California offers a variety of Healthcare Plans to their consumers. Within the spectra of different insurance plans, many Californians select what’s called an HMO plan or Health Maintenance Organization. A Health Maintenance Organization is a type of managed Health care plan hat provides a form of health insurance coverage in the United States that is fulfilled through hospitals, doctors, and other providers with which the HMO has a contract. Unlike traditional indemnity insurance, care provided in an HMO generally follows a set of care guidelines provided through the HMO's network of providers.
Under this model, Blue Cross of California HMO contract with a Health Maintenance Organization to receive more patients and in return usually agree to provide services at a discount. This arrangement allows the Health Maintenance Organization to charge a lower monthly premium, which is an advantage over indemnity insurance, provided that its members are willing to abide by the additional restrictions. With Blue Cross of California, you select your facility from a list of providers within your Health Maintenance Organization. This keeps the premiums to a cost-effective level for the Blue Cross Customer. How do HMO plans work and how are will they help me?
HMO plans where you pay a certain pre-determined deductible before the plan will begin to pay a percentage of the medical bill balance. For instance, if you accrue $1000 worth of medical bills and you have a $250.00 deductible and you will pay $250.00 off of the $1000 leaving a balance of $750.00 dollars. Let’s take this a step further and your insurance pays 80% of the unpaid balance, then Blue Cross of California HMO will pay 80% of the $750.00 and you are responsible for the remaining 20%. If you choose higher deductibles, then you will consequently have a higher out-of-pocket expense before Blue Cross of California HMO will pay on the unpaid balance less the cost of your premium. Which HMO is for you? Well, that’s between you and your health care provider.
Blue Cross of California HMO has contracted with many reputable and excellent physicians, healthcare facilities, and hospitals in California to provide you with the greatest possible care at a reasonable cost. As long as you stay within your HMO you will continue to save money and have affordable premiums. HMO’s also help the patient to save money by hoping to eliminate unnecessary treatments. Your primary care provider (main doctor) will refer you to a specialist if it’s needed. This will help to eliminate duplicate testing and keep medical costs within reason.
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