Health insurance Glossary

Health insurance Glossary
Health insurance Glossary
« Go back to Glossary

COST-BASED HEALTH MAINTENANCE ORGANIZATION

CST-BSD HLTH MNTNNC RGNZTN

A type of managed care organization that will pay for all of the enrollees/members' medical care costs in return for a monthly premium, plus any applicable deductible or co-payment. The HMO will pay for all hospital costs (generally referred to as Part A) and physician costs (generally referred to as Part B) that it has arranged for and ordered. Like a health care prepayment plan (HCPP), except for out-of-area emergency services, if a Medicare member/enrollee chooses to obtain services that have not been arranged for by the HMO, he/she is liable for any applicable deductible and co-insurance amounts, with the balance to be paid by the regional Medicare intermediary and/or carrier.

Related words

Origin of the term used within this page: https://data.cms.gov/

© 2021-2023 HealthInsurance.com, LLC

Privacy Policy  |  Terms and Conditions

GENERAL DISCLAIMERS

Healthinsurance.com is a commercial site designed for the solicitation of insurance from selected health insurance carriers and HealthInsurance.com, LLC is a licensed insurance agency. It is not a government agency. It is also not an insurer, or a medical provider. HealthInsurance.com, LLC is a licensed representative of Medicare Advantage (HMO, PPO, PFFS, and PDP) organizations that have a Medicare contract. Enrollment depends on the plan’s contract renewal.
We do not offer every plan available in your area. Currently we represent nine carrier plan organizations nationally. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
Alternatively, you may be referred, via a link, to a selected partner website, which is independently owned and operated and may have different privacy and terms of use policies from us.
If you provide your contact information to us, an insurance agent/producer or insurance company may contact you. If you do not speak English, language assistance service, free of charge, is available to you; contact the toll-free number listed above. This site is not maintained by or affiliated with the federal government's Health Insurance Marketplace website or any state government health insurance marketplace.
The plans we represent do not discriminate on the basis of race, color, national origin, age, disability, or sex. To learn more about a plan's nondiscrimination policy, please click here.
MULTI-PLAN_TGH-HPIH_WEB_M_2023