Medicare Advantage HMO
What Is Medicare HMO?
Medicare HMOs are health maintenance organizations often referred to as Medicare managed care plans. The insurance company has you select a primary care physician, or PCP, from within your local network. Your PCP will then coordinate your care through that local network of doctors and hospitals. If you need a specialist, your PCP will refer you.
To enroll in a Medicare HMO plan, you must first enroll in both Medicare Parts A and B and live within the HMO service area. Once enrolled, you must stick to the plan’s network of doctors and hospitals, except in the case of an emergency.
What You Need to Know Before You Enroll
You can enroll in a Medicare HMO plan during any election period as long as you don’t have end-stage renal failure.
Some plans have premiums as low as $0. However, premiums can change from year to year.
You must seek care within your local network of healthcare providers, except in emergencies.
Many HMO plans include Medicare Part D drug plans—check to make sure your medications are included!
You will be expected to pay as you go in the form of co-pays or coinsurance.
Review the changes to your plan every year to avoid surprises. These changes take effect January 1.