Medicare HMO Plans are the most popular type of Medicare Advantage plan.
They also are the lowest cost.
Medicare Advantage HMO plans help you customize and expand your Medicare benefits to protect both your health and your bank account.
Below we take a closer look at what these policies have to offer.
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Understanding Medicare HMO Plans
A Medicare Health Maintenance Organization (HMO) is a network of doctors and care providers coordinating all your health care benefits.
The benefits and covered services of your policy are only available from doctors inside the HMO network. In other words, you cannot see any care providers outside your HMO organization.
Here’s How Medicare HMO’s Work:
When you enroll in a Medicare Advantage HMO plan, you designate a primary care physician to be the center point for all your medical care. Any services outside your primary care physician will require a referral from that primary doctor.
This referral process reduces the waste and operating costs of the network by helping eliminate needless services and office visits. As a result, the insurance company can offer monthly premiums.
How HMO Plans Differ From PPO Plans
Medicare PPO plans (proffered provider organizations) differ from HMO plans by allowing you to see any doctor that takes Medicare patients. This type of organization incentivizes its members to use an in-network ‘preferred provider’ by offering lower costs. However, you can schedule services with care providers who are out of network at any time.
Additionally, PPO plans do not require a doctor’s referral. Patients are free to schedule any covered service that they need. Because of these flexible freedoms, the premiums for PPO plans are higher.
Benefits of Medicare HMO’s
- Multiple carrier options in most places throughout the country
- Lower monthly premiums
Who Should Consider a Medicare HMO Plan?
HMO plans are best suited for moderately healthy individuals who do not expect to use their policy benefits to a large degree and do not mind going through the referral process to reduce monthly premiums. Individuals suffering from severe health complications will likely find it more convenient to go with a PPO network policy.
Finding Your Best Plan
Most states have multiple insurance providers offering Medicare HMO’s. All you have to do is shop and compare Medicare Advantage Plans from the providers in your area and enroll with the best one.