Medicare Health Maintenance Organization (HMO)

Medicare Health Maintenance Organization (HMO) plans are common because they offer lower premiums. You must remember you have to be enrolled in Medicare Part B and paying for it. HMO’s require you stay in the network unless of an emergency.  

What is an HMO?

Medicare Health Maintenance Organization (HMO) plans are Medicare managed care plans because your care is through a network of physicians and specialist to that plan. Insurance companies form a relationship with doctors in your area and form a network. You pick a primary care doctor and if they can not help you with a certain medical condition, they can refer you to someone who can. Services such as preventative care, mammograms, and emergency room visits may not require a referral. This plan does not replace Part B of Medicare. You must first have your Medicare Part A and B before getting an HMO plan. You have to live in the plan’s service area or network. When you decide on an HMO plan you are agreeing to obtain your medical care within the plans network. 

General Feature for an HMO plan:

  • No health questions
  • Premiums can be lower
  • Local network of healthcare providers
  • Medicare Part D drug plan
  • You pay as you go
  • Changes annually

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