HMO Plans
Health Maintenance Organization (HMO) is a type of Medicare Advantage plan with low costs and stable coverage.
Medicare Advantage and HMO Plans
When you go on Original Medicare, you will realize that it doesn’t cover everything. So, to get additional coverage, you can join a Medicare Advantage plan that is offered in your area. This type of health plan is an “all-in-one” alternative to Parts A and B.
Your Advantage plan will reduce your out-of-pocket costs for Original Medicare benefits, though you’ll still have to pay your Part B premium, as well as your Part A and Part B deductibles.
For Medicare Advantage, one of the biggest factors in cost and coverage is the type of plan you choose.
What You Should Know About HMOs
Health Maintenance Organization (HMO) plans rely on a network of healthcare providers and locations. By coming into agreement with them, your plan is able to give you lower out-of-pocket costs in-network.
HMOs don’t offer coverage out of their network, meaning you’ll be responsible for 100% of the costs if you go out of the network. But this helps keep your premiums and out-of-pocket costs very low. A fairly small network also lowers your costs. As long as you get care close to home, you won’t have to worry.
You will also choose a primary care provider with an HMO plan, which means you’ll need their referral before you can get specialist care.
Like other Advantage plans, HMOs may also include additional coverage, such as:
- Limited dental, vision, and hearing
- Prescription drugs
- And more!
HMO vs. PPO Plans
The closest alternative to HMO is a Preferred Provider Organization (PPO) plan. If you are willing to pay more month-to-month for a more flexible coverage network, you may be more interested in PPO.
PPOs cost more than HMOs but have a larger overall network and some coverage if you venture out of network. They also don’t require a primary care physician or specialist referral.
Both plans are widely available, and it won’t be hard to find one in your area that best suits your needs. The choice between these types of plans, then, is up to what you’re looking for — flexibility or the lowest possible costs.
An HMO Plan May Be the Solution for You
If you are ready to take the next step towards joining an HMO plan, or still need help deciding, call or email us today!
