HMO Plans

HMO Plans

Private insurance companies sell Medicare Advantage Plans. These types of plans are alternatives to Original Medicare. They offer bonuses like gym memberships, vision insurance, dental insurance, and hearing coverage. The exact details of the plan depend on the plan type. There are multiple types of plan types. One of the most popular plans is a Health Maintenance Organization, an HMO. Read more on HMOs below. 

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Medicare advantage HMO Plans

An HMO is more affordable but less flexible than other plan types. An HMO organizes providers into in-network and out-of-network groups. In an HMO, the insurance company makes agreements with certain providers and hospitals to provide care at a specific low rate. When the patient goes to these in-network providers, they save themselves and the insurance companies money. Unlike a PPO, they cannot see out-of-network providers and still be covered. An HMO emphasizes low cost by having patients stay in-network. 

HMO Pros and Cons

The main advantage of an HMO is the cost. The lower monthly cost makes this a very affordable plan. However, the main drawback is the lack of flexibility. Patients can only be covered if they receive care in-network. This means that any emergency or travel care is not covered and often must be paid 100% by the patient. They must also find a primary care physician (PCP) and use that PCP for referrals to specialists if they need specialist care.