HMO Pros & Cons

A Health Maintenance Organization (HMO) is a type of health plan that offers a wide range of healthcare services through a network of providers who agree to supply services to members. Kaiser Permanente manages the HMO plan offered by Snohomish County. Here is a brief list of the pros and cons of opting for a HMO plan.

Advantages

  • You will have the opportunity to choose a designated primary care physician
  • You will have a network of providers available to your to coordinate your care
  • Typically have lower monthly premiums
  • Typically lower out of pocket expense

Disadvantages

  • If you need specialized care, you will need a referral from your primary care physician to an in-network provider
  • Must see in-network providers for care-less flexibility than a PPO plan

Highlights

Your Kaiser Permanente medical plan provides you with:

  • Core Care options-Doctor Appointment, CareClinic, Urgent Care, Nurse Consult, Care Chat, Online Visit, Email your Doctor
  • Acupuncture- 8 visits per medical diagnosis per calendar year without prior authorization ($20 co-pay)
  • Cancer Screening-Covered as part of Preventative Services according to the Kaiser Wellcare Plan
  • Diabetic Education and training available ($20 co-pay)
  • Manipulative Therapy of the spine and extremities-up to ten visits per year ($20 co-pay and some exclusion apply)
  • Nutrition Counseling ($20 co-pay)
  • Naturopathy-3 visits per diagnosis per calendar year without pre-authorization ($20 co-pay; additional visits covered with preauthorization)

Perks & Benefits