We can answer your questions, help you compare plan options, and give you information about how to enroll in a HMO. Call our office or fill out the request form.

Medicare Health Maintenance Organizations (HMOs) are private plans that administers Medicare benefits and are offered by a private insurance company. An HMO gives you access to certain doctors and hospitals within its network. A network is made up of providers that have agreed to lower their rates for plan members and also meet quality standards. Like all Medicare Advantage Plans, HMOs must provide the same benefits as Original Medicare, but do so with different rules.  These plans contain extra benefits like dental, eyeglasses or a gymnasium membership.

Some other key points about HMOs:

• Most plans have a $0 monthly premium
• Maximum out of pocket are lower than PPO’s
• Primary Care Physicians (PCP) is needed.
• Referrals are needed to visit any specialist or hospital
• Emergency and Urgent care benefits anywhere in world
• Not allowed to use out-of-network providers unless in an emergency
• Part D plans are usually included.
• Lower copayments, and Deductibles then PPOs
• Additional benefits, such as dental, vision and hearing care.

The key questions to ask before choosing a HMO:

• Are my doctors in the network?
• Do I have doctors in other states or counties?
• I am in a budget?
• Do I need the extra benefits?