The Best HMO in Florida

In the state of Florida, both individual and group health insurance markets offer HMO plans, though as one would imagine it is much more heavily based in employer-sponsored plans. As far as knowing which one is the best in all of Florida, East Coast Health Insurance can give you an insider’s perspective on the companies we know inside and out. HMOs are a great way to save money, and it’s a shame more aren’t offered outside of the context of group plans. More Florida insurance companies than the existing ones have been rumored to release individual HMO plans to the public but still have yet to follow through.

AvMed and UnitedHealthcare also carry a HMO products in Florida, but only for Medicare beneficiaries. United just purchased Medica Healthcare Plans in early 2012, catering to Medicare and Medicaid recipients and operates two clinics: one in Coral Gables and one in Hialeah. Additionally, beware of confusion when running yourself a Florida quote, as Aetna, who does offer a great HMO network and plans through the group market, has released a plan called the Health Network Option (abbreviated HNO), which could be confused for an HMO, though it is in fact a POS plan.


Best Individual HMO

There are only a few companies that provide individual plans with an HMO network in Florida, the most reputable ones including CoventryOne and newly in South Florida, HumanaOne. This leaves us to grant the title of Best HMO in Florida for Individual Coverage to CoventryOne. CoventryOne’s HMO plans are available in Broward, Miami-Dade, Martin, St. Lucie and Palm Beach Counties in four different varieties, with even more choices within those types. Their vast options for deductible costs and prescription coverage is definitely reason enough to go with an HMO from CoventryOne.

CoventryOne’s HMOs are offered in several types for various preferences, including deductible or sans-deductible. Their Open Access plans mimic the style of a PPO in that they have a deductible to meet, while their sole Copay plan is a traditional HMO with no deductible and an annual copayment maximum of $5000. This plan functions as though you had group health insurance, with covered services available for a copay ($30 for primary care) as soon as your plan begins, and no waiting to meet the deductible to receive coverage. This plan also keeps care contained to the HMO network only, with no coverage on non-network services.

CoventryOne’s Individual Open Access Focused Deductible HMO plans offer coverage on out-of-network care for emergency room visits only. These plans include a deductible, which can range from $1500 to $10,000 depending on the plan type, in addition to an integrated prescription plan. The pharmacy benefit is only available on specified plans, and otherwise there is a prescription rider on the plans that do not include it. Integrated plans have amazingly low prices on prescription drugs, including $3 for generics and $20 for brand names.

There is no question as to why this is such an effective company, and our top choice for individual health insurance. CoventryOne has gone above and beyond to offer a wide variety of options in their individual HMO plan and out-do any competitor by offering such a network before most of the major insurers in Florida. We highly recommend their portfolio of HMO plans and suggest you investigate for yourself by getting a quote in South Florida now.


Best Group HMO

With every major insurance company offering HMO plans to the group market, it maybe not even be a second thought to consider the quality of the HMO network or who is running the best one in the state. However, we have experienced the whole lot of them and have come to find that UnitedHealthcare offers the absolute highest caliber HMO. Their HMO plans are called UnitedHealthcare Choice, and if you have one through your employer, be very grateful. These plans are available to employers of any size, which is also somewhat rare, as a business as small as two people can receive UnitedHealthcare Choice or Choice Plus benefits.

These plans are open access to any provider within the massive network offered by United. As one of the largest health insurers and overall health system entities in the nation, they have a network across the country that includes over 645,000 doctors and medical professionals and 5105 hospitals. There are no out-of-network benefits, as it is an HMO. Its availability of providers makes it our top choice for group coverage, however. Its plan designs are also exception in quality and offer affordable copayments, care coordination services, and the peace of mind that comes with being claim form and bill-free.

United’s Choice Plus HMO plan offers an even greater number of providers in its network, and there are coinsurance options instead of simply copay amounts. Regardless of which plan type an employer carries, this company wins hands down by creating a cost-effective way to receive quality care in Florida, and around the US. While there is competition, not many other companies can provide this extensive a network for managed care and constant satisfaction among members.

Congratulations to our winners!