Individual Health Plans

Individual HMO Plans

A Health Maintenance Organization, or HMO, is a type of managed care plan that requires members to use in-network providers for all their health care needs.  There is no coverage for services received from providers who are outside of the HMO’s network, with the exception of emergency care.

Plan Features

At Arise Health Plan, we encourage members to select a Primary Care Practitioner (PCP) to coordinate their overall medical care.  A PCP is a participating provider who practices in the area of family medicine, internal medicine, pediatrics, general practice, or obstetrics/gynecology. 

If a member requires health care services from a provider who does not participate in our network and there are no participating providers who can provide those services, the member’s PCP or participating specialist must submit a pre-service authorization to Arise Health Plan prior to the member seeking services from the non-participating provider in order for those services to be considered for payment.