Yes. Let me guide you through this hellscape as Virgil to Dante in the Divine Comedy.

Insurances in the US have a “network” of healthcare providers that they will cover. If you go somewhere out of network, insurance may not want to cover it.

HMO (Health Maintenance Organization) means that you’re basically stuck to the insurance network. You pay less per month, but you can’t go anywhere for care that your insurance doesn’t say you can. If you want to see any sort of specialist, you will need a referral for everything. You always have to start by seeing your primary care provider first, and then they send a referral somewhere to be seen by someone else. Prepare to wait months. And god help you if you have an emergency the next state over and one of the doctors who walks into the room while you are unconscious is out of network. You’ll pay for the whole thing out of pocket.

The alternative to HMO is PPO (Preferred Provider Organization). It costs a lot more per month and the insurance network still applies, but you can choose to seek care effectively anywhere in the network without a referral. If you have a weird skin rash, you can go straight to the dermatologist. Expect to still wait months, but at least you don’t need to wait weeks to be seen by your PCP first. You can also see healthcare providers out of network, but there will usually be a higher upfront cost to do so (your deductible) before insurance steps in to cover. You will have to pay a certain amount yourself before they will start to cover anything, so it’s often still high out of pocket costs until the costs really start to blow up. At which point the insurance plan will start to think of more creative ways to deny coverage anyways.

Trickle-down Holynomics