Characteristics of an HMO plan usually include:

An HMO (Health Maintenance Organization) plan is specifically designed to manage healthcare costs while providing a comprehensive set of services to its members. One of the defining characteristics of an HMO is that it primarily offers in-network only coverage. This means that members are required to seek care from a defined group of doctors, hospitals, and other healthcare providers that have agreements with the HMO.

This model is aimed at controlling healthcare costs, ensuring that members receive preventive care, and encouraging the use of a coordinated healthcare approach. When members go outside of this network for care, they typically face significantly higher out-of-pocket costs or may not be covered at all, except in emergencies.

While emergency care coverage and referral requirements for specialists can be features of HMO plans, and premiums may vary, the essential defining trait that distinguishes HMOs from other types of health insurance plans is the restriction to in-network providers for non-emergency services. This focus on network-based care is critical to understanding how HMOs operate and their approach to health management and cost containment.