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HMO Plans

Health Maintenance Organization (HMO) Plans

When you have one doctor managing your care, it helps keep you healthier. With an HMO plan, it is recommended that you choose a primary care practitioner (PCP) who will help coordinate overall medical care. Your PCP is your main point of contact for health care, the doctor who takes care of you and coordinates with other health care professionals, such as specialists, when necessary.

 

HMO plans offer:

  • FREE preventive care. 100% coverage for preventive services, such as annual exams, screenings, and more, when performed in-network.
  • $0 copay preventive drugs. $0 copays on select preventive drugs that target common medical conditions, such as high blood pressure and diabetes.
  • Affordable access to Aspirus Network providers. Aspirus offers four regional hospitals in Wisconsin, four more in Michigan, 50 clinics, and more than 400 physicians.

With an HMO, you must get health care from in-network health care providers. If you receive care from an out-of-network provider, the HMO plan will not pay for that care unless prior authorization was approved or the condition was deemed an emergency.

 

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HMO Plans