HMO Overview

HMO Blue is a commonwealth health approved plan which provides great value for individuals, small groups and families looking to purchase health maintenance organization insurance.  HMO Blue meets the Minimum Creditable Coverage Stds as of the beginning of last year.  Your care starts under your primary health provider which you must choose under a standard HMO for yourself and each family member.  There are many ways to look for a PCP or primary care provider starting with the Blue Cross & Blue Shield website or by calling their phone number, 18008211388.

HMO is becoming a popular health insurance plan

If you have concerns about choosing a doctor under the HMO Blue plan, BCBS’ Physician Selection Service may be able to assist you with the necessary information.  They can provide you with the doctors’ qualifications, specialty, and other relevant information you may need to make an informed decision.  HMO Blue will also refer you to a specialist in cases of emergency care as deemed appropriate by your PCP depending on the treatment of your condition.  You may also discuss matters about a specific specialist you may already have in mind.

A solid HMO plan is necessary for good coverage

Under HMO Blue, your provider may work with BCBS about Utilization Review Requirements; these include Pre Admission Review, Discharge Planning and Concurrent Review, Individual Case Management, and Prior Approval Outpatient Services as is detailed in the subscriber certificate.  The deductible will be calculated yearly.  You need to meet the deductible for some services before benefits are given.  You can contact your group if you are unsure of when your plan begins.  The plan year amount is $250 per member, or double, for families.

Office visits, emergency room visits, out-patient mental health and preventive health services are not subjected to year plan deductibles.  In cases of emergencies wherever you may be, you can directly go to your nearest hospital or dial 911 and the $200 co payment fee is waived when you are admitted.  In case you are traveling outside of the plan’s service area, you’re covered for one follow-up and urgent care visit.  Any succeeding visits may be fixed by your chosen PCP. This plan also includes dependent benefits. The plan may cover full time unmarried students who do not qualify as being eligible dependents.  These are only some of the benefits you get from the plan.

Looking for HMO Blue policy? Sign up now and get the chance to compare multiple quotes from different policies. Get the worth of your every penny through our free online insurance quote.