Medicare Advantage HMO Plans
What are Medicare Advantage HMO Plans?
Medicare Advantage Health Maintenance Organization plans are provided by US private Medicare insurance carriers with a network of healthcare providers and facilities. They come with low monthly premiums while offering more benefits than Original Medicare plans.
How Medicare Advantage HMO Plans differ from PPO Plans
Although they look similar, there are several key differences between Medicare Part C HMO and PPO plans. These include:
- Healthcare services outside the network
Medicare Advantage HMO plans do not cover medical assistance received outside your carrier’s network while PPO plans do.
- Choosing a primary care physician
With HMO plans, you have to select only one primary physician for all your healthcare, but with PPO plans, you do not have to choose.
- Referrals
Unlike PPO plans, you need referrals to visit specialists PPO plans.
- Premiums
HMO plans come with lower premium costs in comparison to PPO plans as they are less flexible
The benefits of enrolling in Medicare Advantage HMO plans
HMO plans offer more coverage than Original Medicare Plans at little to no additional premiums and they include:
- Chronic condition healthcare services and support
- Adult day-care services
- Dental, vision, and hearing
- Fitness, nutrition, and wellness
- Over-the-counter medication
- Doctor’s visit transportation.
With HMO plans, however, you can only receive healthcare services outside your plan’s network in emergencies. You are also limited to one primary care physician and only they can refer you to other healthcare specialists.
To find out the best Medicare HMO plan premiums in your area you can get in touch with our licensed Medicare Agents to get free Medicare help.
Medicare Advantage HMO Enrolment periods
The HMO Advantage Enrolment periods fall under Medicare Part C enrolment periods and they are as follows:
- Initial Coverage Election Period
It falls under the seven months that are three months before and three months after you turn 65. Those who are under the age of 65 and living with a disability are eligible for Medicare Advantage after receiving Social Security Benefits for 25 months. Their enrolment period is three months before and after the 25th month of receiving Social Security benefits.
- Annual Election Period
This period begins from the 15th of October to the 7th of December every year. Your Medicare coverage will take effect on the 1st of January the following year and before this time, you can freely make changes to your Medicare Advantage plans.
- Medicare Advantage Open Enrolment Period
During this period, beneficiaries are allowed to change their Medicare Advantage plans or migrate to Original Medicare plans.
- Special Election Period
When certain scenarios such as moving out of your Medicare Advantage coverage area or moving into a nursing home occur, special enrolment periods are open on an individual basis, allowing you to change your Medicare HMO plans.
Need help choosing a Medicare Advantage plan?
Our licensed Medicare insurance agent is ready to help you.