Health Insurance
HMO (Health Maintenance Organization)
A health plan with a tight network and required referrals from a primary care physician.
Last reviewed: May 2026 · Editorial methodology
Definition
A type of health insurance plan that requires you to use a network of doctors and hospitals and get referrals from a primary care physician (PCP) before seeing specialists. HMOs typically have lower premiums but less flexibility than PPO plans. Out-of-network care is generally not covered except in emergencies. Kaiser Permanente's integrated model is a high-profile HMO example.
Where this term matters
💡 Tip
Related terms
Related guides
Cover Forge USA Editorial Team
Editorial Lead
This article was researched and written by the Cover Forge USA editorial team against federal sources (NAIC, CMS, FEMA, DOL, SSA, state DOIs) and standard policy forms. Bylines organize content by topic — they do not assert individual licensure. See our editorial-policy for details.
Reviewed 2026-06-14
Get Insurance Rate Alerts
We monitor rate filings in all 50 states. Get notified when rates change in your area — and discover new ways to save.
- ✓State-specific rate change alerts
- ✓Seasonal enrollment deadline reminders
- ✓Expert tips to lower your premiums
- ✓New coverage options in your state
Free forever. Unsubscribe with one click. No spam, ever.
Important Disclaimer
This site provides general educational information only and is not a substitute for professional insurance advice. All rates, data, and coverage details are estimates and may not reflect your actual premiums. Insurance availability and pricing vary by state, insurer, and individual risk factors. Always consult a licensed insurance professional in your state before making coverage decisions.