These are very popular health insurance plans with several insurance companies in California, most noticeably Kaiser Permanente. To be a member in a Health Maintenance Organization (HMO), you are obligated to obtain your health care services from doctors and hospitals affiliated with the HMO. Typically as a member of an HMO, you are required to choose a primary care physician who treats and directs health care decisions and who would refer you to different specialists within the HMO network if you needed to see another doctor. Health Maintenance Organizations often are employers of the doctors and hospital personnel within the HMO. HMO’s offer limited coverage for medical procedures not performed by your designated doctor or hospital or that occur outside the HMO network due to the fact that they operate within a restricted geographic region. In California, an HMO is required to cover medically necessary emergency services even when outside of their coverage area. The idea behind an HMO is to still offer quality medical services that maintain affordability through managed care products. Just like their PPO counterparts, an HMO provides access to a broad package of covered health care services as long as you pay your monthly premium. You can get multiple Arizona family health insurance quotes as well as California quotes by entering your zip code on the home page. offers multiple plan options that enable you to choose your deductible or copay amount, all of which vary the monthly premium you will pay for an HMO plan.

HMOs in California are regulated by the DMHC. HMOs are required to have an internal complaint/grievance process in place.

Important Things to Remember Regarding Health Maintenance Organizations:

  • If you are a member, you are required to obtain health care services from HMO providers, except in certain emergency situations.
  • You choose your doctor, so this is a key decision because that physician directs your care. That doctor will often coordinate referrals to specialists within the HMO.
  • Your options may be limited by the geographic restrictions of the HMO network.
  • Depending on the plan you choose at enrollment, you may have a co-payment each time you utilize an HMO covered service.
  • You can seek assistance from the DMHC on all HMO and managed care questions, and you have any additional coverage questions please contact us at by clicking on the Contact tab at the top of the screen.