A Medicare Advantage HMO plan is a type of Medicare Advantage plan. Medicare Advantage plans, also known as Medicare Part C, are offered by private insurance companies that contract with Medicare.
Like all types of Medicare Advantage plans, HMO plans must offer the same coverage as Original Medicare. However, they may offer these with different restrictions, rules, and costs.
What is an HMO?
This is a Health Maintenance Organization plan through which you can access your Medicare benefits. Medicare Advantage HMO is usually known as managed care plans because your healthcare is administered via a network of hospitals and doctors detailed to the Medicare Advantage plan. The carrier contracts with hospitals and doctors in your area to create a network, so you will be required to choose a Primary Care Physician (PCP) who will coordinate your healthcare.
When you join a Medicare Advantage HMO, you agree to get your healthcare through the plan’s network, except during emergencies.
Suppose your primary care physician can’t treat your health condition. In that case, they will issue a referral for you to see a specialist. You may not need a referral for some services like emergency visits, mammograms, and preventive care.
Who is Eligible for Medicare Advantage HMO Plan?
To enroll in any Medicare Advantage plan, you must first be enrolled in Original Medicare. The first time you can enroll in a Medicare Advantage plan is during the Initial Enrollment Period, which is a seven-month period that surrounds your 65th birthday. You may also enroll during the Annual Enrollment Period from October 15 to December 7.
Learn More About Medicare Advantage HMO
Reviewing each Medicare Advantage HMO plan is a challenging task. You may need to get help from a licensed health insurance agent that specializes in Medicare products. At Heritage First, we can provide you with insightful information and help you choose the right plan for you. Contact us for help today!
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