Short answer: Pros: lower premiums, low predictable copays, and coordinated care. Cons: you must stay in network, need referrals for specialists, and have no out-of-network coverage except emergencies.
HMOs are the most cost-controlled common plan type. Advantages include lower premiums, simple low copays, and a primary care physician who coordinates your care. The disadvantages are flexibility: you’re limited to the network, need a referral to see a specialist, and have no coverage for non-emergency out-of-network care. They fit members who value cost savings and don’t mind a more managed experience.