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When it comes to obtaining health care coverage for those age 65 and over, there are various options available. In addition to Original Medicare (Medicare Parts A and B), there are numerous HMO plans, available through the Medicare Advantage program, that could provide additional coverage such as dental, vision, and hearing – along with reduced out-of-pocket expenses. These Plans can also offer flexibility and choice to help meet diverse health care coverage needs.
In an HMO, or Health Maintenance Organization, enrollees are typically required to pay a fixed fee each month for the health care services that they receive. This is in lieu of paying a separate charge for each visit or service. In most cases, these monthly fees will stay the same, regardless of the level or type of services that they receive. The health care services are provided either by individuals or entities that are employed directly or under contract with the HMO.
Oftentimes, HMOs will differ in their design. For instance, depending on how an HMO is set up, the services it provides could be offered through a central facility. Or, alternatively, patients may be seen in individual physicians’ offices instead. In addition, those who have their health care coverage via an HMO won’t usually have to submit any of their own claims to the insurance company.
In most HMOs, participants will be required to use the services of the doctors and facilities that are listed within a network of providers – other than in an emergency. Enrollees may also be required to obtain a referral from their primary care physician in order to see a specialist.
In certain Medicare Advantage HMO plans, participants may be able to see an out-of-network provider, but only at a higher cost. This is referred to as an HMO with a POS, or point of service, option.
Oftentimes, prescription drugs will be covered in an HMO Plan. It is important to be sure that this particular benefit is included, however, as it is not an automatic option in all of the Medicare HMO plans that are available in the marketplace today.
One of the key features that HMOs are known for is their focus on preventive care and wellness. These entities seek to reduce the cost of health care through the identification and early treatment of illness – before it becomes a more serious issue. With this in mind, HMOs will oftentimes provide incentives for those who lose weight or quit smoking.
When shopping for a Medicare Advantage HMO plan, it is important to keep several things in mind. First, the cost of these plans can vary a great deal, depending on the benefits that are offered, as well as the geographic area. With this in mind, it is a good idea to compare the cost of more than one plan before making your final choice.
We work with many of the top rated Medicare Advantage carriers in the industry, and can help you to quickly and easily compare premium costs of the different Medicare Advantage plans available in your area.. Simply use the form on this page to start the process, and you’ll be on your way to ensuring your coverage with a new Medicare Advantage HMO Plan.