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Medicare Advantage plans are an alternative way to get your Medicare Part A and Part B coverage. Rather than getting your benefits directly through Medicare, you receive your benefits through a private insurance company that has contracted with the Social Security Administration. Medicare Advantage plans, or Part C plans, come in a variety of different types. One of the possible plan structures is a Health Maintenance Organization (HMO) plan. Here’s what you need to know about this type of plan.

Medicare Advantage plans are an alternative way to get your Medicare Part A and Part B coverage. Rather than getting your benefits directly through Medicare, you receive your benefits through a private insurance company that has contracted with the Social Security Administration. Medicare Advantage plans, or Part C plans, come in a variety of different types. One of the possible plan structures is a Health Maintenance Organization (HMO) plan. Here’s what you need to know about this type of plan.

Health Maintenance Organization Plans

Health Maintenance Organization plans are a type of Medicare Advantage plan that requires participants to seek health care services from in-network providers. If they choose to seek care outside of their network, there is a chance that those services will not be covered by the policy. In some cases, out-of-network providers may be available depending on your plan’s rules.

With an HMO plan, you will need to have a primary care physician in most cases. Through this doctor, you can get the referrals that are needed to see specialists. Though, some services may not require a referral. For example, annual mammograms do not require a referral under HMO plans.

Finding In-network Doctors

If you have an HMO plan, you will be better off seeking care from in-network providers. Finding in-network health care providers may be difficult, but there are often platforms available to help you find health care workers that participate in your plan. Before enrolling in a plan, make sure you check their network to see if your preferred providers are included. If they aren’t, consider checking out other plans in your area.

Drug Coverage On HMO Plans

Most HMO plans also include prescription drug coverage. This is good because Medicare Advantage plan members cannot purchase Part D prescription drug coverage.

Additional Benefits In HMO Plans

Medicare Advantage plans are not standardized, so they can include additional benefits that are useful to their members. With many HMO Advantage plans, you can find supplemental benefits like free meal delivery and low-cost transportation to and from health care visits. Some plans may even include hearing, dental, and vision coverage, benefits which are not provided by Original Medicare.

Other Advantage Plans

If you are planning to shop for Medicare Advantage plans, you should be aware of the other types of plans too. These are some other plan types you may need to consider:
Preferred Provider Organization – These plans allow you to seek care outside of your plan’s network, offering more flexibility at a higher cost.
Private Fee-for-Service – These plans negotiate specific rates with providers, and they can choose whether or not to accept patients.
Special Needs Plans – These plans are designed for people with specific illnesses, disabilities, or life circumstances. They offer specialized benefits and may have a unique cost structure.

HMO Plans In Your Area

Don’t wait to get the coverage you need. Start shopping for Medicare Advantage plans now, with the help of Weinstein Wealth Insurance Solutions. We have the knowledge needed to help you find the plan you need to maintain your health for years to come.