Open ended HMOs allow subscribers to have flexibility in deciding through whom they want their healthcare services. Health care services can be coordinated through a primary care physician while making nominal co-payment amounts; or, the subscriber can select a physician of his or her own choice who is out of the HMO plan. Selecting physicians out of an HMO plan still entitles the person to benefits obtained as part of the network. However, in such an instance, the person would have to fill out claim forms and would be held liable for a higher amount of medical expenses. In the second instance, it can be as expensive as individual health insurance programs.

Physician outside Network

If a person decides to opt for a physician out of an HMO plan, he or she would need to pay deductible amounts of approximately $300 when opting for an individual health insurance plan. After these payments are made, the insurance policy will offer payment for 70% of expenses that are covered under the plan. The rest of the expenses are paid by the subscriber. However, the upper limit for money spent would not be over $3,000 in the case of individual plans or $9,000 for another plan. This amount is the maximum limit payable annually by the individual so long as it is essential to pursue medical care.

When it is Beneficial

Open-ended HMOs where the person selects their physician of choice out of the network has several benefits. For example, if the patient is comfortable with a particular physician and does not want to divulge from that routine, such a plan is advantageous. Another advantage of such a plan is if the individual intends to take a leave of absence it enables added flexibility for them. At other instances, if the person's place of residence is not in close proximity to the HMO facilities or clinics, it makes more sense to be able to choose a physician of the individual's preference.

In the context of individual health insurance programs, where the insured is responsible for a majority of expenses, an open-ended HMO allows extra flexibility in the selection of a physician. If the person is comfortable with a particular physician or does not have the advantage of close proximity to an HMO clinic, he or she can opt for health care through a physician of their choice. The costs of associated visits with open-ended HMOs are treated just as with conventional medical claims for insurance and include annual co-payments as well as deductibles. While the overall expense of these trips can be significantly higher compared to conventional indemnity policies, many people prefer the flexibility such HMO plans offer.