What type of reimbursement is not provided by an HMO?

Health Maintenance Organizations (HMOs) operate on a managed care model that emphasizes providing integrated healthcare services primarily through a network of providers. The key feature of HMOs is that they often require members to use their network of designated providers for care. This model allows them to control costs and maintain quality by managing healthcare delivery more closely.

When considering the reimbursement structure of an HMO, it becomes clear that one of the defining characteristics is that they do not provide reimbursement for services outside of their contracted network. This generally includes payments for out-of-network services, as membership in an HMO typically involves a commitment to use specific healthcare providers who have agreed to certain pricing and service levels with the HMO.

While HMOs promote preventive care services and often cover those essential services at no additional cost to the member (beyond the premium), they do not expand their reimbursement to cover care received outside of their networked providers. A member opting to seek care outside of this network usually finds that they must bear the full cost, as HMOs are not designed to reimburse these out-of-network expenses.

Therefore, when considering the types of reimbursements an HMO provides, the correct identification of the aspect that is not included is 'reimbursement' for out-of-network services,