HMO stands for Health Maintenance Organization. HMO plans typically have lower monthly premiums. With an HMO you can typically expect to pay less out of pocket. With most HMO plans, all your healthcare services are coordinated by your primary care provider (PCP). Most HMOs require you to obtain a referral from your PCP to see a specialist. HMOs do not offer coverage for care from out-of-network healthcare providers. The only exception to this is for medical emergencies or urgently needed services.
HMO-POS stands for Health Maintenance Organization – Point of Service.
An HMO-POS is a Medicare Advantage Plan that is a Health Maintenance Organization with a more flexible network allowing Plan Members to seek care outside of the traditional HMO network under certain circumstances or for certain treatment. You generally get your care and services from doctors, other health care providers, or hospitals in the plan’s network. However, you are able to go out-of-network for certain services, usually for a higher cost.