Health Maintenance Organization (HMO) plans are one of the many types of Medicare Advantage plans. It offers the coverage you’d get with Original Medicare, with special forms of coverage missing from traditional Medicare. However, there are some considerations to take when joining.
All HMO plans offer inpatient and outpatient coverage. Some also provide coverage for medications. This is why HMO plans can be seen as a combination of Medicare Parts A and B, with Part D added in with some plans.
You will not be able to add on Part D if your HMO plan does not offer prescription drug coverage. In order to get prescription coverage while enrolled in this plan, you must enroll in a plan that already has prescription drug coverage included.
Your additional coverage benefits include dental, vision, and hearing. These services are not covered under Original Medicare, but can be covered by HMO plans.
HMO plans restrict coverage to a network of providers, except in the case of emergencies. This network can change over time, as providers come and go each year. If you get out-of-network treatment, you may not get any coverage at all, and you may have to pay the full price for your treatments.
You will also select a primary care physician when you join. This will be someone who will guide the course of your treatment and refer you to specialists when necessary.
It’s important to be aware of the healthcare providers who accept your plan’s coverage. This way, you can avoid confusion and the possibility of paying more out-of-pocket.