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What Is An Open Ended HMO For Low Cost Health Insurance?

By Cathy Wilson Posted in Health Insurance News

Health Maintenance Organizations (HMO) is a group of health care providers within a community who have agreed to provide health care to their members including sick care treatment. This means that members receive coverage through a group of doctors and facilities that work directly for the HMO. Every patient is required to pick a primary care physician within this group who will then direct the insured’s medical needs through one of their clinics.

Open-Ended HMO Plans

An open-ended health plan, also called The Rensselaer Health Plan, gives you flexibility by choosing who you want your medical care through. You have a choice of coordinating your health care through your primary care physician and paying a small co-payment, or choosing a doctor of your own choice outside the HMO network. If you choose a doctor outside the network you are still entitled to benefits from the network but you will have to fill out a claim form and you will be responsible for more of the medical expenses.

What Does Open-Ended HMO Health Coverage Mean For Me?

If you choose to go to a doctor outside the network, you will be responsible to pay a deductible of $300 for an individual plan ($900 for a family plan) then your insurance will pay for 70% of the cost of covered expenses, and you will pick up the rest. You will never spend more than $3,000 for an individual plan ($9,000 for a plan) in one full year as long as medicinal care is necessary.

The RHP might be the right plan for you if you like options including receiving health care from a physician of your own choice, if you are planning on taking a leave of absence, or if you do not live close to the HMO clinics and facilities.

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1. What Does A Non-network Health Insurance Plan Do And Mean?
2. What Is A Managed Care Health Insurance Plan?
3. What Kind Of Health Insurance Should I Have As A Parent?
4. What Is A Point Of Service Health Insurance Plan?
5. What Is A Network Based Health Insurance Plan?