Medicare Advantage HMO Plans

Health Maintenance Organization (HMO) plans offer healthcare services through a network of providers at lower prices than other Medicare Advantage programs. You can qualify for an HMO plan if you already have Original Medicare (Parts A and B). 

Advantage plans cover everything that’s in Original Medicare plans and provide extra benefits, including coverage for prescription drugs.

How HMO Plans Are Structured

Part C plans all use healthcare provider networks. However, HMO plans are more reliant on their networks than most others. If you have an emergency, HMO programs enable you to rely on out-of-network care. Otherwise, you’ll have to visit a primary care physician if you need a check-up for a specific issue. The physician will also refer you to a specialist if you need more specialized treatment.

Therefore, you’ll usually have a single option when you require treatment immediately—except in cases of emergencies. Most HMO members don’t mind this factor too much since the plans are cost-effective and enable them to receive healthcare for low or no premiums every month.

HMO is the perfect Advantage plan for you if you need a low-cost healthcare plan that offers excellent benefits.

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Comparing HMO to PPO

Preferred Provider Organization (PPO) and HMO plans are the most widely used out of all Medicare Advantage plans. If you’re choosing between these two, you need to decide how flexible and cost-effective of a healthcare plan you want. PPO plans are more expensive than HMO but offer a wider network if you need it, without requiring you to choose a primary care physician or get referrals. Both PPO and HMO are good options that will help you significantly cut down your out-of-pocket expenses. 

Find The Right Medicare Advantage Plan For You

At Scott Sims Insurance, we ensure that our clients will receive the Medicare plan that they need. We will help find you a plan within your budget and work with you, so you understand each of your options.

To learn more about Medicare Advantage plans, contact us through our website or call our Oregon office at (541) 915-0939​​​​​​​​.