Medicare Advantage HMO Plans

If you have Original Medicare coverage, you will be able to receive care from any provider as long as they accept Medicare. With Medicare Advantage plans, you may be restricted to receive your care from very specific providers. For example, Health Maintenance Organization (HMO) plans are more restrictive than other Medicare Advantage plans, but because of this, you will pay less out-of-pocket.

*Disclosure: Do keep in mind that Dale Frank Financial offers insurance products, but is not affiliated with Medicare or the U.S. government.

Now, if you are considering an HMO plan, here is what you need to know.

Medicare Advantage Plans

All Medicare Advantage plans, also referred to as Part C, provide you with your Part A and Part B benefits in a single plan. You may also get your Part D prescription drug coverage through a Medicare Advantage plan, making them a versatile option for qualified Medicare beneficiaries. All Medicare Advantage plans are offered through private insurance carriers.

The type of Advantage plan you choose will determine which doctors you have access to and whether you need a referral to see specialists. The plan you have may also decide whether you need to have a primary physician to coordinate your care.

HMO Plans

With an HMO plan, you will have to select a primary care physician and get a referral from this same physician if you need specialist care.

In most cases, prescription drugs are included in HMO plans, but this is not a guarantee. Check with your insurance agent to ensure that your preferred plan has prescription drug coverage if you need it.

You will also be expected to stay within the provider networks of the plan to receive care. While some may not like this option, this could ultimately save you money in the long run as HMOs will not provide coverage outside of their networks unless it is for an emergency. Because of these restrictions, HMO plans are generally less expensive than other Advantage plans, such as Preferred Provider Organization (PPO) plans.

Medicare costs

Medicare Advantage plans are also known to have other additional benefits besides prescription drug coverage. Some of these benefits include:

  • Dental coverage
  • Vision coverage
  • Hearing coverage
  • Transportation
  • Meal delivery
  • Adult daycare
  • And more
Find An HMO Plan Today

Dale Frank Financial has the answers you need. Contact us now to receive a free quote on Medicare Advantage HMO plans in your area. Our phone number is (413) 665-8324.



Understanding Medicare: Know Your Options and Costs

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Download this 16-page guide and get answers to the most common questions about Medicare, including:

  • What’s the difference between Medicare Parts A, B, C and D?

  • What's covered? And how much will I pay?

  • Is Medicare Supplement insurance or a Medicare Advantage plan right for me?


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