Understanding HMO Insurance Plans

In today’s world, navigating the world of health insurance can often seem like a daunting task. From Boca Raton to Greenacres and Port St. Lucie, the team at Absolute Best Insurance is committed to helping you make sense of it all. 

Among various options available, HMO insurance plans remain a popular choice. But what exactly does an HMO insurance plan cover? Let’s delve deeper.

What is an HMO?

First things first, it stands for Health Maintenance Organization. It’s a specific type of health insurance plan that stipulates you must select a primary care physician (PCP), who becomes your main point of contact for all health-related issues. Your PCP can refer you to specialists within the network if necessary.

Your plan will most likely not cover a visit if you choose to use a doctor outside of the network. Staying in your network is what will help you get the most out of this kind of plan.


An HMO is a health insurance plan where you select a primary care physician who oversees your healthcare, referring you to specialists within the network.

Preventive Care Coverage

Under these plans, most preventive care services are covered. This is a proactive approach to healthcare, emphasizing the prevention of disease before it occurs.

Preventive services include routine check-ups, immunizations, screenings, and wellness visits. The idea is to maintain your health and wellness by catching potential problems early on.


Preventive care services such as routine check-ups, immunizations, screenings, and wellness visits are covered.

Medical Treatments

In addition to preventive care, these plans cover a wide range of medical treatments. These include, but are not limited to, hospital stays, surgeries, emergency services, and sometimes mental health care. However, remember that coverage typically requires a referral from your PCP, barring emergency situations.


HMO’s cover medical treatments including hospital stays, surgeries, and emergency services, subject to a referral from your primary care physician.

Specialty Care

When your health needs extend beyond the scope of your PCP, plans like this have you covered. While your PCP serves as your primary healthcare provider, you may require specialized services from medical professionals such as dermatologists, cardiologists, or orthopedic surgeons.

However, it’s critical to note that a referral from your PCP is usually required to see a specialist. This means your co-pay for the visit may be more than what you pay for a regular doctor visit.


Receiving care from a specialist, necessitating a referral from your PCP is covered but may cost more.

Absolute Best Insurance: Your Partner in Health

At Absolute Best Insurance, we specialize in creating individualized solutions to meet your specific healthcare needs, including explaining and facilitating any plan of your choosing. 

Our team is ready and eager to help you ask the right questions, identify your specific needs, and voice your concerns so we can best meet them. Best of all, our services won’t cost you a thing! From Greenacres to Port St. Lucie and Boca Raton, we’re dedicated to providing the absolute best in health insurance, Medicare plans, and more. 


Absolute Best Insurance offers personalized solutions for health insurance, Medicare plans, and more, with locations in Greenacres, Port St. Lucie, and Boca Raton. Our services are free!


Choosing the right health insurance is a critical step toward maintaining your health and well-being. An HMO insurance plan, with its broad coverage and proactive approach to healthcare, can be an excellent choice for many individuals. They cover preventive care, medical treatments, and specialty care, often making healthcare more accessible and affordable.

However, understanding your unique needs and how different plans align with them is crucial. The professionals at Absolute Best Insurance are here to help. From explaining their complexities to answering your questions and addressing your concerns, we offer comprehensive assistance to ensure you get the most out of your coverage.

Connect with us Today!

If you’re interested in learning more about HMO plans or other coverage options, feel free to reach out to us at Absolute Best Insurance. Our dedicated team across Boca Raton, Greenacres, and through the Treasure Coast to Port St. Lucie is committed to providing the highest standard of service to our clients. We look forward to hearing from you and helping you secure the best possible insurance coverage for your specific healthcare needs.

Remember, when it comes to insurance, you deserve the Absolute Best. Contact us Let’s create your individualized insurance solution together. To learn more click here or give us a call at (561) 420-0280.