Health Maintenance Organization (HMO) Work in Nigeria

Health maintenance organization (HMO) work by providing health care services to their affiliates through health care providers that they enter into contracts. The agreement entered with the health providers allow payments to be lower. Health providers have the other benefit of having patients sent to them.

The origin of Health Maintenance Organization (HMO) goes back to the early 1900s when establishments started providing their staffs with plans of prepaid medical services. Health maintenance organization (HMO) has become very popular because of their fewer charges. When compared to alternative health care policies sold by insurance companies.

health maintenance organisation (HMO)

Health Maintenance Work (HMO)?     

Health maintenance organizations go into agreements with hospitals, medics, doctors, and clinics in order to offer health care services within a particular region. For an individual or group to belong to a Health Maintenance Organization (HMO) they should be employed or living in the HMOs service area or within its network.

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A participant of Health Maintenance Organization (HMO) is required to make use of the doctors assigned to them in the service areas. Except in the case of an emergency where different, urgent health care is needed. The Health Maintenance Organization (HMO) plan covers the participant, their significant other and their children in case of illness. After registering with a Health Maintenance Organization (HMO), the contributor is needed to choose a primary care physician from a list of doctors within the network.

The PCP oversees all your health care and if you need a referral, the PCP is the one who gives you a referral. Pick your primary care physician wisely as all health care that you require will be attained through them.

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What Contributors of a Health Maintenance Organization (HMO) pays

First, there are premiums; these are monthly charges made by contributors of Health Maintenance Organization (HMO). Employees who belong to an HMO have their contributions taken from their basic salary every month. Some employers pay a certain percentage of their members while others don’t pay at all. Secondly, there are co-payments; this is a fixed charge a person pays for a medical service under a plan, usually after receiving the service.

Co-payments differs according to service with emergency or specialized care being costlier. Lastly, Health maintenance organization (HMO) has deductibles. This is the money you pay out from your pockets before the health insurance pays anything towards your medical expenses.

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Factors to consider in choosing Health Maintenance Organization(HMO)

Before picking a health plan, endeavor that you get to know what the plan covers and whether it is appropriate for you or not. With Health maintenance organization (HMO), you will receive cheap medical costs. These are the following factors:

  1. Know the hospitals that the HMO’s network covers.
  2. Is your ideal doctor in the HMO’s network?
  3. Are the doctors and hospitals situated close to you?
  4. How much will you have to pay for the premiums, co-payments, and deductibles?
  5. Are other participants of the plan satisfied with the services?
  6. Feel free to check out the terms and condition of the facilities you intend selecting.