They must be told that; To get coverage under the plan, clients must visit participating providers inside the network; otherwise, they will be responsible for the full cost of the service.
Urgent care, emergency care, and renal dialysis treatments are the only exceptions to the provider network requirement. This is further explained below.
Generally, A health maintenance organization (HMO) is a kind of health insurance plan that offers health care via a network of physicians in exchange for a monthly or yearly charge.
In conclusion, Clients must be informed that they will only be eligible for plan benefits if they get care from in-network participating providers.
There are a few exceptions to having a provider network, and they include urgent care, emergency care, and renal dialysis treatments. More detail about this is provided below.
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