Medicare HMO Policies

Just because someone is elderly or disabled doesn't mean she doesn't want options anymore. Medicare has plenty of options, include Medicare private health plans known as Medicare Advantage plans. Medicare Advantage plans are as varied as any other health insurance policies on the market.

Definition

Medicare Advantage plans are available as HMO policies. HMO stands for health maintenance organization and it is a type of managed care plan.

Network

HMO beneficiaries are limited to a network. They must see doctors and specialists within their network, and they must select a primary care physician.

Benefits

Medicare HMO policies must cover the basic Medicare benefits. HMO plans will typically offer additional coverage such as dental, vision and preventive benefits.

Premium

HMO plans will require the beneficiary to pay a monthly premium. Most of the time, this is either equal to or more than the monthly traditional Part B premium. Some HMO policies pay part of the premium for the beneficiary.

End-Stage Renal Disease

Those who are Medicare-eligible due to ESRD are not eligible to join most Medicare HMO policies. There are a few special needs plans HMO policies that are made specifically for those who have ESRD.

References

• Medicare Interactive: What is a Medicare HMO?
• Medicare Interactive: How does a Medicare HMO work?
• Medicare.gov: Medicare Advantage Plans

Resources

• Medicare & You Handbook (PDF)
• Medicare HMO