What must HMO members utilize to get covered care?

Prepare for the Nebraska Life and Health License Exam with our interactive quiz. Use flashcards and multiple choice questions for thorough exam readiness. Access hints and explanations for every question!

HMO members must utilize the HMO's network of providers and caregivers to receive covered care because HMOs (Health Maintenance Organizations) operate under a model that emphasizes the use of a specific network of healthcare providers. This network is designed to manage costs while providing coordinated care, thereby ensuring that services are delivered efficiently and with the oversight of the HMO.

By using network providers, members benefit from lower out-of-pocket costs and enhanced care coordination. The structure encourages preventive care and helps to keep the overall health expenses manageable. If members go outside the network for non-emergency care, they typically won't receive reimbursement, making the network an essential aspect of an HMO's operation.

While the option concerning the primary care physician may seem relevant, it is specifically the network of providers that defines how care is accessed in an HMO, with the primary care physician serving as a key point of access within that network. Therefore, the correct choice highlights the requirement to use the established network for covered services.

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