Medicare HMO Plans

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 that coordinate all your health care benefits.  

The benefits and covered services inside your policy are only available from doctors inside the HMO network. Therefore your plan does not cover services performed outside of your local HMO network.    

Here’s how a Medicare HMO works:

When you enroll in a Medicare Advantage HMO plan, you will designate a primary care physician to be the center point for all your medical care.  

You will need a referral from your chosen physician for all services that your primary doctor cannot perform. 

This referral process reduces waste and operating costs by restricting your ability to schedule care services. Of course, those benefits are still there; however, you will need to go through your primary care physician to do so. 

Insurance companies know the referral process is a hassle; however, it does cut down on operating cost, which allows carriers to offer lower monthly premiums.  

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Difference Between Medicare Advantage HMO & PPO

There are two main types of Medicare Advantage policies, HMO’s and PPO’s. The main difference between these two types of policies is how you receive your benefits. 

As discussed above, a Medicare HMO policies require a referral process for all services outside your primary care physician. And you can only see health care providers inside your local HMO network.  

Medicare PPO plans are a bit different. PPO stands for Preferred Provider Organization. Unlike HMO policies, PPO’s allow you to see any doctor that accepts Medicare. However, these plans incentivize you to see an in-network ‘preferred provider’ by offering lower costs for in-network services. 

The other main difference is that PPO plans do not require a referral from a primary care physician to schedule and receive the benefits within your policy.  

PPO plans provide greater freedom and flexibility in how you receive your health care benefits. However, this flexibility increases the operating cost of the PPO network and, as a result, increase the cost of your monthly premium. PPO plans are almost always higher costs than HMOs. 

Who Should Consider A Medicare HMO Plan?

As discussed above, Medicare Advantage HMO plans cost less than Medicare PPO plans. Therefore, HMO’s are really for any individual looking for a low-cost Medicare Advantage policy. 

HMO plans are best suited for moderately healthy individuals who do not expect to use their benefits to a large degree. Remember that all care services outside of your primary care doctor require a referral. Those suffering from severe health complications will likely find it more convenient with a PPO network policy.  

Finding Your Best Plan

Most states have several insurance providers offering Medicare Advantage Plans. Therefore, consumers have options when shopping for their best policy and price. 

Our independent agency helps you shop your options by pulling quotes from all the available carriers operating in your state.  

We take the time to understand your health situation and help you pick the right policy type that fits your needs and your budget. 

Our experienced agents are experts in all things Medicare. We’re here to answer all your questions and help maximize your Medicare benefits.

Our services are free.  And there’s never any obligation when speaking with an agent.

Explore your Medicare Advantage HMO options today. Get started by filling out the form on your screen.

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