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HMO Plans
Health Maintenance Organization (HMO) is a type of Medicare Advantage plan offered by private companies.
Call Now 312.945.0361
HMO Plans
Health Maintenance Organization (HMO) is a type of Medicare Advantage plan offered by private companies.
How does an HMO Plan work?
Generally, HMO plans offer services from doctors, other health care providers, or hospitals in the plan’s network (except for emergency care, out-of-area urgent care, or temporary out-of-area dialysis, which is covered whether it’s provided in the plan’s network or outside the plan’s network). However, some HMO plans, known as HMO Point-of-Service (HMOPOS) plans, offer an out-of-network benefit for some or all covered benefits for a higher copayment or coinsurance.
HMO Plan Basics
With an HMO plan, you must choose a primary care provider and, in most cases, obtain a referral to see a specialist. Additionally, your plan may have specific rules, such as requiring pre-approval for certain services before they are covered. It is crucial to adhere to these rules to maintain your insurance coverage.
Size of Network:
One or more counties
Plan Availability:
Most common Medicare Advantage plan
Specified Primary Care Physician (PCP):
Yes
Referrals Required:
In most cases, yes
Maximum Out-of-Pocket:
Yes (in-network only)
Ready to enroll in a HMO Plan now?
To apply for a Medicare Advantage plan, you must first be enrolled in both parts of Original Medicare. Enrollment periods are specific, so you should discuss these with your agent. If you’ve already spoken to one of our Complete Coverage agents, click on their name below to enroll yourself today.
Maximize your coverage, consult an agent today.
We can help you find a policy tailored to your needs and navigate the complexities of a Medicare Advantage plan, ensuring you have peace of mind with proper coverage.