What is a health maintenance organization (HMO)?

• A. A plan that allows members unlimited access to any physician
• B. A type of health insurance that requires members to use a network of doctors
• C. A government-run health care program
• D. A financial service providing loans for medical expenses

Answer: (B)

A health maintenance organization (HMO) is a type of health insurance that operates on a network model, requiring members to obtain their healthcare services from a specific group of doctors and facilities. This structure helps to control costs and ensure coordinated care among healthcare providers. Members typically need to select a primary care physician who manages their healthcare needs and provides referrals to specialists within the network when necessary. The focus on a restricted network allows HMOs to negotiate better prices with providers and emphasize preventive care, which can contribute to better health outcomes at a lower overall cost.

The other options do not accurately define an HMO. Unlimited access to any physician refers to more flexible insurance models, such as Preferred Provider Organizations (PPOs), while a government-run health care program relates more to public healthcare systems rather than HMO structures. Additionally, financial services for medical loans are unrelated to health insurance plans.