Individuals who join an HMO are considered members. Typically HMOs provide members with comprehensive health care. That primary care physician coordinates all of that member's medical care. If care by a specialist is needed, the primary care physician will refer the member to a specialist who is usually also in the HMO network. In an HMO, physicians may be employees of the HMO or the HMO may contract with independent physicians to provide care.
Care is provided to each member of the plan for a fixed amount.
Typically, an employer contracts with an HMO to provide care for its employees and pays this fixed charge. If you are part of a Medicare HMO, than Medicare pays the fee. If the HMO is efficient and keeps its members healthy, it will make a profit. If it has too many members who require costly sick care, its profits are smaller or it may lose money.