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Can an HMO be an HDHP?

Lively · November 20, 2018 · 3 min read


No matter if you are actively reviewing your health insurance plan options during [open enrollment]( or just getting a refresher in your health insurance knowledge, we have the comparison you need. We will review HMOs and HDHPs below. We will also see if an HDHP can be classified as an HMO.

Understanding different health insurance options

You are likely familiar with healthcare plans like PPOs, HMOs, and HDHPs, but what are the characteristics that make them unique? You can compare healthcare plan by understanding:

  • Costs (Deductible, out-of-pocket)

  • Plan coverage

  • Care Network

Surprised? It really is that basic. With this foundation, we can review the details of each plan type and better understand how they are unique and/or similar.

What is an HDHP (high-deductible health plan)?

A High-Deductible Health Plan (HDHP) is a healthcare plan traditionally defined by lower premiums and higher deductibles. The IRS sets annual minimum deductibles and annual out-of-pocket maximums for individuals and families. The health insurance plan must be so that the individual pays the first cost of health care up to the deductible before any kind of insurance kicks in, with the exception of preventative care, which is exlcuded before the deductible.

What is an HMO (Health Maintenance Organization)?

Health Maintenance Organizations (HMOs) aim to keep down overall medical costs by creating a narrow network of providers whose care the health plan will cover, and by requiring all patients to get the approval of their primary care provider (PCP) before they see a specialist, have a test done, or receive just about any other type of care.

Under all HMOs, the PCP will manage the patients’ care and there is little to no paperwork for the patient to complete.  Which sounds great because it’s low maintenance for the patient.  The drawback is that the patient has very little choice in terms of the doctors he or she sees since the only care that’s covered is in-network care.  So, if you found a doctor you liked outside of the health network, you would have to pay for the care 100% out-of-pocket.

Traditional HMO plans tend to have lower premiums and deductibles than other types of plans, which lead to lower out-of-pocket costs for the patient.  There is also an efficiency of care because it’s managed by one person, the PCP.

Overlap between HDHP and HMO plans

As you can see above, HDHPs are defined by deductibles and out-of-pocket costs, not the network in which your coverage resides. So? That means comparing HDHPs to HMOs is like comparing apples to oranges. In this, there can be overlap. HDHPs are based on cost parameters. HMOs are based on network parameters. So, yes! An HDHP can be an HMO If it meets the parameters outlined in both sections above.

Staying informed of your healthcare options

Healthcare plans are all about the fine print. They are constantly changing. What was true last year, might not be true this year. Be vigilant about your health plan comparison. Incorporate this into your yearly open enrollment strategy. Next year, you will be a healthcare expert.

Get started with Lively

If you have a qualifying high-deductible health plan, you can sign up for a Health Savings Account with Lively today, even outside of open enrollment. With a Lively HSA you can enjoy a triple-tax advantage and savings on every day healthcare needs. Learn more and get in touch today to open your account.



Lively is the modern HSA experience built for—and by—those seeking stability in the ever-shifting healthcare landscape. By harnessing modern innovation and deep industry expertise, Lively is committed to bridging today’s savings with tomorrow’s unknowns. Unlike traditional institutions hindered by bureaucracy, Lively’s commitment extends beyond initial set up to providing dedicated, ongoing support and education for every step. So each HSA can reach its maximum potential with minimal headache.

piggy bank on pink background


2024 and 2025 HSA Maximum Contribution Limits

Lively · May 9, 2024 · 3 min read

On May 9, 2024 the Internal Revenue Service announced the HSA contribution limits for 2025. For 2025 HSA-eligible account holders are allowed to contribute: $4,300 for individual coverage and $8,500 for family coverage. If you are 55 years or older, you’re still eligible to contribute an extra $1,000 catch-up contribution.

comparing hsa versus fsa


What is the Difference Between a Flexible Spending Account and a Health Savings Account?

Lauren Hargrave · February 9, 2024 · 12 min read

A Health Savings Account (HSA) and Healthcare Flexible Spending Account (FSA) provide up to 30% savings on out-of-pocket healthcare expenses. That’s good news. Except you can’t contribute to an HSA and Healthcare FSA at the same time. So what if your employer offers both benefits? How do you choose which account type is best for you? Let’s explore the advantages of each to help you decide which wins in HSA vs FSA.

Benefits of HSA employer matching

Health Savings Accounts

Ways Health Savings Account Matching Benefits Employers

Lauren Hargrave · October 13, 2023 · 7 min read

Employers need employees to adopt and engage with their benefits and one way to encourage employees to adopt and contribute to (i.e. engage with) an HSA, is for employers to match employees’ contributions.

Disclaimer: the content presented in this article are for informational purposes only, and is not, and must not be considered tax, investment, legal, accounting or financial planning advice, nor a recommendation as to a specific course of action. Investors should consult all available information, including fund prospectuses, and consult with appropriate tax, investment, accounting, legal, and accounting professionals, as appropriate, before making any investment or utilizing any financial planning strategy.



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