What does an HMO plan typically require from its members?

An HMO, or Health Maintenance Organization, plan typically requires its members to select a primary care physician (PCP) who serves as the main point of contact for healthcare needs. This PCP is responsible for providing routine care and acting as a gatekeeper for any specialist services. In order to see a specialist, members usually need to obtain a referral from their designated primary care physician.

This structure is designed to manage healthcare costs and ensure that patients receive coordinated care. By requiring members to go through their primary care physician for specialist visits, HMOs can better control the utilization of specialty services, encourage preventative care, and maintain a more systematic approach to patient management. This model helps ensure that patients receive the appropriate care while also minimizing unnecessary treatment and healthcare expenses.

Options that suggest greater freedom in selecting specialists or imply higher costs without the requirement of referrals do not align with the HMO model, as this type of plan emphasizes care coordination through primary care physicians.