What is an HMO?
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eHealth, Inc. is the parent company of eHealthInsurance Services Inc., the leading online source of health insurance for individuals, families and small businesses. eHealthInsurance presents complex health insurance information in an objective, user-friendly format, enabling the research, analysis, comparison and purchase of health insurance products that best meet consumers' needs.
Licensed to market and sell health insurance in all 50 states and the District of Columbia, eHealthInsurance has developed partnerships with more than 160 health insurance companies, offering more than 7,000 health insurance products online.
The company's technology platform is able to communicate electronically with insurance carrier partners, which enables a simpler, more streamlined health insurance application process. This technical connection with the back-office processes of health insurance companies can facilitate rapid approval of applications and real-time communication between carrier and consumer throughout the process.
eHealthInsurance provides consumers with transparency of information about a broad array of health insurance plans with a selection of price and benefit options, complemented by a full-service Customer Care Center of highly trained customer service representatives. Available via a toll free number, online chat, email or fax, the Customer Care team answers consumer questions throughout the process of buying and using health insurance.
eHealthInsurance was founded in 1997 and its technology was responsible for the nation's first Internet-based sale of a health insurance policy. We are headquartered in Mountain View, California.
<span>The content provided by eHealthInsurance on this Website is for informational purposes only. This content is general in nature, and is not intended to be a substitute for advice from a licensed insurance agent. </span>
What is an HMO?
Senior Vice President of eHealthInsurance Bob Hurley explains the structure and function of an HMO or Health Maintenance Organization.
Transcripts
Host: What is an HMO?
Bob Hurley: An HMO is a Health Maintenance Organization. An HMO is basically, a contracted network of doctors in hospitals, in pharmacies. The insurance companies or the Health Maintenance Organizations put together these networks in an effort to, number one, negotiate aggressively with them on price and then the idea would be that once they have negotiated pricing with the doctors and the pharmacies and the hospitals, they would then go out and sell health insurance products or maintenance products to consumers at lower rates than what they could get otherwise because of this well defined discounted, negotiated pricing that they have achieved with some of these providers.
Often times, you hear the terminology 'Gatekeeper' referred to in HMOs because typically your care is well managed. Health Maintenance Organization means managed care and so they are attempting, they, mean the maintenance organizations are trying to manage your care and so they often set up a number of gatekeepers so that when you access the healthcare system you have to go through various different gates to get to the next level of care. The thinking being that they are going to help you manage not only, getting the care you need but also manage the cost of that care by making sure that you only get procedures that are needed and you only get them from contracted providers whether they be doctor and hospitals or pharmacies and so again, a health maintenance organization typically is going to be very involved in the management of your care and often times, in most of the cases they are referred to as managed care.
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