Health Maintenance Organizations

Medicare Health Maintenance Organization (HMO)

A Medicare Health Maintenance Organization (HMO) is a type of Medicare Advantage Plan that provides affordable healthcare while ensuring comprehensive coverage. This plan offers several key features:

  • In-Network Providers: HMOs require you to choose healthcare providers within their network to manage your care efficiently.
  • Lower Costs: Typically, HMOs are more cost-effective compared to other Medicare Advantage Plans.
  • Additional Benefits: Many HMO plans include extra benefits like dental, vision, and over-the-counter allowances.

Coordinated Care through a Primary Care Physician (PCP)

With an HMO, your care is coordinated through a primary care physician (PCP). This includes obtaining referrals to visit specialists, ensuring streamlined healthcare management.

Medicare Part C Coverage

Medicare HMOs fall under Medicare Part C and are offered by private companies. These companies manage your Medicare benefits by combining:

  • Medicare Part A (Hospital Coverage)
  • Medicare Part B (Medical Coverage)
  • Optional Medicare Part D (Prescription Drug Coverage)

By integrating these parts, HMO plans provide the same essential benefits as Original Medicare while offering added value through comprehensive and coordinated care.

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