Health Maintenance Organization FAQs

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Q. What is an HMO?

A. An HMO is an alternative method for the delivery of health care services, with a view toward achieving greater efficiency and economy in providing these services. Health Maintenance Organizations are prepaid health care plans.

Q. I had HMO group coverage through my employer. Recently, I terminated employment and moved to Florida. My employer has over twenty employees, but he says I can't have a COBRA extension. Why not?

A. Because the subscriber left the geographic area of the HMO with the intent to relocate or establish a new residence outside the organization's geographic area.

Q. Are newborn and adopted children automatically covered under an HMO program?

A. All HMO contracts which provide coverage, benefits, or services for a member of the family of the subscriber shall provide coverage, benefits, or services with respect to an adopted child from the moment of placement in the residence of the subscriber. In the case of a newborn, coverage shall begin from the moment of birth, if a written agreement to adopt such a child has been entered into by the subscriber prior to the birth of the child.