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Health Maintenance Organization (HMO) Plans
With an HMO health plan, you can offer your employees high-quality care and great value. You and your employees get full access to in-network providers while effectively managing health care costs.
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 plan, it is recommended that each member choose a primary care practitioner (PCP) who will help coordinate overall medical care. There is no referral necessary to see an in-network specialist, but some services will require review and prior authorization. If you receive care from an out-of-network provider, the HMO will not pay for that care unless prior authorization was approved or the condition was deemed an emergency.