Health Maintenance Organizations (HMOs) under Medicare Advantage offer a structured, cost-effective way to receive comprehensive healthcare coverage, serving as an alternative to Original Medicare. With HMOs, you can benefit from a coordinated network of healthcare providers, often with lower premiums and added benefits like vision, dental, and prescription drug coverage. However, understanding how HMO plans work and what they cover is crucial to making an informed decision. Our licensed Medicare experts are here to simplify the process and help you find the HMO plan that best fits your needs—continue reading to discover how an HMO could enhance your Medicare experience.
Health Maintenance Organizations (HMOs Medicare Advantage Plans are an alternative to Original Medicare (Medicare Part A and Part B).
Under Original Medicare, the government pays for your Medicare-covered health care services and products as you receive them. Under Medicare Advantage, meanwhile, Medicare pays approved private companies to provide your Medicare benefits.
Medicare Advantage (MA) Plans are voluntary, but any MA Plan you join will provide all your Medicare Part A (hospital) and Part B (medical) coverage. Medicare Advantage (also called Medicare Part C) Plans have to provide all the benefits covered by Original Medicare except one. Whether you have a Medicare Advantage Plan or not, Original Medicare covers hospice care.
MA Plans are available to people already enrolled in Medicare Part A and Part B who live in a plan’s service area. People with Medicare Advantage Plans normally pay a monthly MA Plan premium along with their Medicare Part B premium.
Among the popular Medicare Advantage options are Medicare Private Fee-for-Service Plans, Medicare Medical Savings Account Plans, Medicare Special Needs Plans, Health Maintenance Organization Plans, and Medicare Preferred Provider Organization Plans.
Preferred Provider Organization (PPO) Plans can provide great coverage and flexibility by allowing you to use doctors, hospitals, and providers outside your plan’s network. You can save money by staying within the network, but you have the option, at additional cost, of going outside the network for medical services.
The cost of joining a PPO Plan can vary widely depending on which plan and company you choose. Although insurance companies offering Medicare Advantage plans have to follow certain rules set by Medicare, companies have flexibility when it comes to setting out-of-pocket cost requirements. There are many important details to sort through, and MedicareMall is eager to help you determine which PPO Plan may or may not be right for you.
PPO and other Medicare Advantage Plans always cover emergency and urgent care. MA Plans can also provide additional coverage in various areas of health including dental, vision, and hearing, and most plans include prescription drug coverage.
Availability of Preferred Provider Organization Plans can vary from area to area. To find out what’s available where you are, you can contact MedicareMall toll-free at 877-413-1556 or visit www.medicare.gov. You can also find some great information about PPOs and other Medicare Advantage Plans here.
You should be aware that any Medigap plan you have will no longer pay deductibles, co-payments, or other cost-sharing under your Medicare health plan if you enroll in a PPO or another Medicare Advantage Plan. Although you have a legal right to keep your Medicare supplement plan after signing up for Medicare Advantage, it may not be to your advantage to do so.
If you’d like to know more about PPO Plans, one of our licensed, bonded representatives will be happy to answer any questions, discuss all the options with you, or even help you enroll within minutes in the plan of your choice.
Contact us now and we’ll make sure you’ve got the coverage you need at a price you can afford.
Medicare Advantage Plans Index