What requirement is typically associated with HMO plans?

In Health Maintenance Organization (HMO) plans, a key requirement is that members must obtain referrals from their primary care physicians (PCPs) in order to see specialists. This means that the primary care physician acts as a gatekeeper for accessing healthcare services. When an HMO member needs specialized care, they first consult with their PCP, who then assesses the need for a specialist's services and provides a referral if necessary. This model is designed to coordinate care and manage costs by ensuring that all treatment is integrated within a primary framework, typically leading to a more efficient healthcare system for the members.

The structure of HMO plans emphasizes care management, which includes requiring referrals as a way to control healthcare spending and ensure that the patient receives appropriate care. This approach contrasts with more flexible plans that might allow members to access specialists directly without a referral.