Insurance Glossary

Insurance Term - Health Maintenance Organization (HMO)

Prepaid health plans which cover doctors’ visits, hospital stays, emergency care, surgery, preventive care, check-ups, lab tests, X-rays, and various therapies. In a HMO, one must choose a primary care physician who coordinates all healthcare aspects and makes referrals to any specialists that may be required. In a HMO, one must use the doctors, hospitals, and clinics that participate in the network plan. No benefits are reimbursed for non-emergency benefits provided outside the HMO network. Emphasis is on preventative medicine, and members must use contracted health-care providers. In other words, it is a healthcare system that assumes both the financial risks associated with providing comprehensive medical services (insurance and service risk) and the responsibility for healthcare delivery in a particular geographic area to HMO members, usually in return for a fixed, prepaid fee. Financial risk may be shared with the providers participating in the HMO. Thus, HMO is a prepaid managed care plan that provides specified services to enrolled members through designated hospitals and doctors for a fixed premium per person.

Health Insurance Topics

• About Ombudsmen
• An Introduction - Indian General [Non-Life] Insurance Companies
• An Update on UK Health Insurance
• Apollo Munich Health Insurance Company Limited - Benefits, Easy Health Policies, Disease Specific Plans
• Awareness about Healthcare Insurance in India
• Bajaj Allianz Senior Citizens Health Insurance
• Bharti AXA Health Insurance Plans
• Cholamandalam (Chola MS) Health Insurance Policies - Key Features, Eligibility and Claim Benefits
• Comprehensive Health Insurance Scheme in Tamil Nadu - Eligibility, Procedure, Features, Benefits
• Critical Care Health Insurance Plan

• Customer Care in Health Insurance Industry
• Employee State Insurance Corporation (ESIC)
• Exide Life Critical Illness Rider Enhances Your Base Policy against Critical Illnesses
• Fraudulent Health Insurance Claims
• Future Generali Insurance-Group Health-Group Personal Accident-Accident Suraksha
• HDFC Ergo General Insurance - Health Suraksha, Critical Illness Insurance
• Health Insurance
• Health Insurance - Common Terms and Definitions
• Health Insurance Basics
• Health Insurance For Pre-Existing Conditions
• Health Insurance for Senior Citizens - Comparison Chart of Policies, Mediclaim Policy
• Health Insurance for Senior Citizens in India – General Guidelines
• Health Insurance in Europe
• Health Insurance in India - An Introduction
• Health Insurance In India - An Overview
• Health Insurance Plan
• Health Insurance Policies - Fine Prints
• Health Insurance Policies Offered by Bajaj Allianz Insurance
• Health Insurance Portability and Accountability Act [HIPAA]
• Health Insurance Portability Now a Reality
• Health Insurance: Learn About Third Party Administrators (TPA)
• Healthcare Plans from ICICI Lombard General Insurance Company
• Iffco-Tokio General Insurance Pvt Ltd - Medishield Policy, Personal Accident Policy, Swasthya Kavach, Critical Illness Policy
• Insurance Agent - Your Friend and Your Guide
• Insurance Concepts and IRDA [Insurance Regulatory and Development Authority]
• Key Procedures for Filing a Healthcare Insurance Claims
• Max Bupa Health Insurance Company Limited
• National Health Insurance Schemes
• National Health Policy - Policy Thrust
• National Insurance – Health insurance Policy for Senior Citizens

• National Insurance Company Ltd
• Oriental Insurance - Individual Mediclaim, Happy Family Floater, Personal Accident Policies
• Oriental Insurance - Senior Citizen Specified Diseases Insurance
• Overview on USA Healthcare Insurance
• Premium Calculation by Health Insurance Companies
• Raheja QBE General Insurance Pvt Ltd
• Reliance General Insurance - Health Gain Policy, Critical Illness Cover, Personal Accident Insurance Coverage
• Royal Sundaram General Insurance Company Limited
• Senior Citizen Health Insurance Plans in India | Health Insurance Plans for Senior Citizens in India
• Shriram General Insurance-Claims-Liability Policy-Personal Accident
• Star Health and Allied Insurance - Senior Citizens Red Carpet
• Star Health and Allied Insurance - Travel Corporate
• State Health Insurance Programs
• Student Health Insurance Options
• Tata AIG General Insurance Company Ltd
• The Mediclaim Policy: 2007
• The New India Assurance - Senior Citizens Mediclaim Policy
• TPA (Third Party Administrator) for Claims and Cashless Health Insurance
• United India Insurance Company - Senior Citizen Health insurance
• United India Insurance Company Limited - Mediclaim Accident Family
• Universal Sompo General Insurance Pvt Ltd
• What is Medicare / Medicaid? - Eligibility - Payment - Reference
Health Insurance Blogs