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Health Maintenance Organization (HMO) Overview

Health Maintenance Organization (HMO) Overview

At CDPHP, our HMO plans cover a complete array of in-network care with low out-of-pocket costs for all covered services. Just select an in-network doctor to act as your primary care physician (PCP) and we’ll take care of the rest!

HMO plans include:
  • Affordable copayments for doctors visits
  • No charge for certain preventive care, including routine annual physicals, immunizations, and screenings
  • OB/GYN visits without a referral
  • Worldwide coverage for emergency care

How it Works

With an HMO simply select a primary care physician (PCP) from our network of doctors and that doctor coordinates your care and refers you to network specialists as needed. You are responsible for paying a small fee called a copayment when you visit a doctor, fill a prescription, or visit a hospital.

FAQs

How do I change my primary care physician (PCP) or OB/GYN?

You can change your PCP or OB/GYN after logging into cdphp.com using your member ID and password. If you need help choosing a physician, please contact the CDPHP Member Services Department or use our Find-A-Doc tool.

This summary offers highlights but does not detail all benefits, limitations, or exclusions. It is not a contract and may be subject to change. For more detailed information, a Membership Certificate is available upon request.

Note: All non-emergency health services must be provided by a Capital District Physicians’ Health Plan, Inc.® (CDPHP) participating provider (including hospital admissions) unless otherwise pre-authorized by CDPHP.