A Health-Maintenance Organization or HMO is a relatively recent alternative to an indemnity plan. HMOs require that a patient receive treatment at a particular health center or within a specific group or "circle" of providers, except for emergency or specialized care which can not be provided in that way. Most of the options on the Harvard health care menu, including HUGHP and Harvard Community Health Plan, are HMOs.

Indemnity Plan

Traditional health insurance plans such as the old Blue Cross/Blue Shield are often called indemnity plans. They allow patients to make unconstrained choices about who will provide care, and cover all treatments and appointments recommended by a provider, sometimes with deductibles or copayments (see above).

Managed Care

Many insurance companies and health plans have begun introducing programs which require some kind of monitoring or approval of the health care choices made by patients or referrals by doctors. These can include mandatory second opinions for some procedures, "utilization reviews" monitoring the effectiveness of treatment plans, guidelines for the length of hospital stays for particular procedures, and other similar measures.

Point-of-Service

A point-of-service plan is a hybrid between an indemnity plan and an HMO. Patients can choose any provider, but are encouraged to stay within a particular circle. Typically, "out-of-network" choices are discouraged with deductibles or large co-payments, while "in-network" care is covered fully or with only small co-payments. Labor Donated