Does MinuteClinic Accept HMO Plans?

Does MinuteClinic® accept HMO health insurance plans?

Yes, MinuteClinic accepts HMO plans. We accept most insurance plans, but we recommend that you confirm your coverage before visiting us. You can do this by contacting your insurance company. Understanding your coverage will also allow you to prepare for your visit in case there are any out-of-pocket costs you’ll need to pay. You can also find more information on coverage at MinuteClinic on our Insurance and Pricing page.

What is an HMO plan?

“HMO” stands for “Health Maintenance Organization.” This type of health insurance plan allows you to use the services of an extensive range of in-network healthcare providers. These in-network providers agree to supply their services to members under the HMO plan.

Compared to other plans, HMO plans often offer coverage for a broader range of preventative services. HMOs also require you to choose a PCP (primary care physician) who will handle most of your common healthcare needs. To see a specialist, your PCP will need to make a referral.

You should also know that, starting in 2022, any referrals that need to be made will have to go through your PCP first. For MinuteClinic, that means that if one of our health care providers recommends that you get help outside of MinuteClinic, they will have to connect with your PCP before making a clinical referral.

What are some of the characteristics of an HMO plan?

An HMO plan is a health insurance option that may offer lower monthly premiums (the monthly fee you pay for health insurance). Compared to other types of plans, HMO plans can also make it easier to access preventative care services regularly. This includes things like checkups and immunizations, as well as ongoing care for chronic conditions. Most HMO plans also have:

• No deductible (the amount you pay before coverage begins)
• No out-of-pocket limit
• Lower out-of-pocket costs

What's the difference between an HMO and PPO plan?

HMO plans often have lower premiums, but the amount of coverage you will receive is usually less than a PPO plan. With a PPO plan, you don't need a referral to see a specialist. Most HMO plans make you choose a PCP (primary care physician) who must refer you to a specialist. With a PPO plan, you don't need to choose a PCP and referrals are unnecessary, but the premiums are likely higher. You're also likely to see more out-of-network providers under a PPO plan, but HMO plans require you to remain in-network to get coverage.

What's the difference between an HMO and EPO plan?

EPO and HMO plans are similar to each other because they both use a specific network of health care providers and facilities. EPOs can also require you to choose a primary care physician. However, EPOs don’t make you get a referral to see a specialist. EPO networks also tend to be larger than most HMO networks. Both types of plans require you to pay for the entire cost of care if it's outside of your network unless it's an emergency.

Related Articles:

What payments does MinuteClinic accept?
Does MinuteClinic accept FSA & HSA?
Does MinuteClinic accept Medicare & Medicaid?
Does MinuteClinic accept PPO Plans?
Does MinuteClinic accept EPO Plans?

References used as sources for this page:

1. EPO Health Insurance Plans - Health Maintenance Organizations. Available at: https://www.ehealthinsurance.com/health-plans/hmo  (Accessed October 19, 2021)
2. HMO vs PPO: What's the difference? TheStreet. Available at: https://www.thestreet.com/personal-finance/hmo-vs-ppo-14935578  (Accessed October 19, 2021)
3. HMO vs. EPO vs. PPO: Which is better? What’s the cheapest? Available at: https://www.singlecare.com/blog/hmo-vs-epo-vs-ppo/  (Accessed October 19, 2021)