HMO simply means ( Health Maintenance Organization). HMOs are health insurance providers that act as middle men between hospitals and individual or organization. The only difference between HMOs and Insurance companies is that HMOs specializes only on providing health insurance coverage while insurance companies provides general insurance coverage.
HMOs mode of operation is more like an insurance company. Most people prefer their service to insurance companies because they narrowed their services on providing health insurance coverage. Unlike insurance companies that combines all the insurance services at a go.
How does HMOs work?
As stated above, HMOs mode of operation is closely related to that of insurance companies. They provides primary and auxiliary health services to it subscribers. What they do is that they reach agreement with hospitals, specialists, doctors or any health care institutions that can provides excellent health care services up to their own standard.
The agreement between Hospitals and HMOs is usually a case of “help me, I help you“. The HMOs will refer patients to the hospital and the hospital will pay the HMOs an agreed percentage based on the number of patient that came to the hospital through them. So basically, it’s usually a case of win-win for both parties.
Sometimes the Health care institution that enters contract agreement with HMOs will give them an agreed sum of money which will enable the HMOs to offer low premium than other form of health insurance coverage and at the same time maintain high quality health care delivery.
Things to consider before you choose an HMO
- When you are on the cross road; confused on the HMO to sign up for, the first thing to consider is the quality of health care to be rendered. Google or research more on their selected health care give. If their selected hospital is not up to your standard, then you should turn their offer down.
- Another major thing to consider before you sign up for HMOs service is the premium rate. You should know your pocket before you subscribe HMOs service.
- Area of specialization of the selected hospital. You may not need the kind of services that the selected hospital offer in such situation, you should consider looking elsewhere
- You should also consider the hospital’s record on responsiveness incase of emergency. What time frame are they expected to arrive in the event of emergency.
- High rating from experts. You should consider level and standard of the hospital as well
- Have it in mind that a quality health insurance plan helps you to stay well as well as get better after treatment.
- Check the exceptions of the policy, the exceptions i mean the does and don’ts attached to the policy
- Check if they have quick claim and settlement or treatment process. Not when health challenges comes they will start referring you from one section of the hospital to the other.
There are some standard HMOs in Nigeria that can provide you the best service incase your are looking for one. The truth is, if you are looking for health insurance coverage, you should consider subscribing for HMOs because they tend to do better than some insurance companies.
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