Insurance and HMO Information:

Washington State health insurance companies offer many types of plans/products, including:

·         Preferred Provider Organizations (PPOs)

·         Exclusive Provider Organizations (EPOs)

·         Place of Service (POS)

·         Health Maintenance Organizations (HMOs)

Most health plan types are compatible with the Seattle Medical Associates practice model.  A specific exception is the HMO plan/product type.  SMA cannot accept HMO patients for our primary care practice model; per State of Washington regulations.

HMOs require members to use a network of specific healthcare providers.  HMO patients must select an HMO primary care provider (non-SMA provider) to direct all of their care.

Please note that many plans/products (or Qualified Health Plans (QHPs)) offered through the Washington State insurance exchange (Washington Healthplanfinder) are HMOs.  In some locations, you may also be able to locate PPO, EPO, or POS plans allowing consumers to choose based on their needs and preferences.

Not all Washington state Qualified Health Plans (QHPs) are HMOs. They include various types of plans, such as HMOs, PPOs, and EPOs.

As you select a health insurance plan that best meets your needs, questions may arise.  We advise you to consult with your health insurance broker or the specific health plan for clarification regarding your needs and further identification of their plan types, e.g., HMO, PPO, EPO, POS, etc.