For insurance plans, HMO stands for Health Maintenance Organization. In an HMO plan, you’re required to choose a primary care physician within the provider network. From there forward, pretty much all of your healthcare needs must first run through that doctor, and if a specialist is needed, then he or she will refer you to another in-network provider.
Many people like HMOs for the simple value they provide, while others get frustrated by not being able to go outside of their network, with a few exceptions.
When it comes to accessing addiction treatment programs, an HMO plan can make it difficult to find a facility that fits your needs. Since there is rarely, if ever, any out-of-network coverage, in order to get the substance abuse and mental health benefits of the policy patients are required to use the services of contracted facilities only.
Unfortunately we have had many people contact us believing that their insurance will cover a high percentage of their treatment costs, only to find out it only applies to specific programs. Sometimes we are able to find appropriate facilities that are also in network, depending on the location and insurance carrier.
If you have an HMO, contact us today to find out more about your coverage and see what rehabilitation center options may be available to you.