HMO Plans

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Medicare HMO Overview

A Medicare HMO is a Medicare Advantage plan that you can join as an alternative to Original Medicare. Medicare HMO plans are the most popular type of Medicare Advantage network option. Medicare HMOs are so prevalent because of the lower premiums that they offer. In some cases, that premium may even be $0.


What is a Medicare HMO?

Medicare HMOs are health maintenance organizations. It is a way of getting Medicare coverage through a private insurance company. HMO Networks usually require that, unless, in an emergency, you only see in-network providers, doctors, and hospitals. Typically you will be required to choose a primary care provider, who can give you referrals when you need to see a specialist.
Some HMO plans offer a Point-of-Service feature so that you can see out-of-network providers in some circumstances, such as traveling.
Medicare HMO plans are not a replacement for Medicare Part B. You must be enrolled in both Medicare Part A and B to enroll in a Medicare HMO.


Common Features of Medicare HMO plans

  • The one and only health question that you will be asked when applying for a Medicare HMO is if you have End-Stage Renal Failure.
  • Premiums may be lower than the cost of Medigap plans. Some plans in some areas may even have $0 premiums. These monthly premiums can change each year. You should always review your Annual Notice of Change letter, which will tell you any changes that will be taking place in your Medicare HMO plan in the upcoming year.
  • The Annual Notice of Change Letter, mentioned above, will give you notice of any changes to the benefits formulary, pharmacy network, provider network, premium, and co-pays, and coinsurance. These changes will take place on January 1 of each year, and it is important that you read and review this letter when you receive it each fall.
  • You must use healthcare providers that are in your network, and you will be required to choose a primary care provider to coordinate referrals to specialists when needed. You may find companies that offer HMO-POS plans with higher premiums, which will allow you to receive some out-of-network services.
  • Many HMO plans include Medicare Part D drug plans, but it is always best to check that your medications are included in the plan.


Which Insurance Companies Offer Medicare HMO Plans?

Many popular insurance companies offer Medicare HMO plans, including Aetna, Anthem, Blue Cross Blue Shield, and Cigna. Availability varies based on location, and we can help you by checking availability in your county.


How can I get a quote?

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👋  I’m Anthony, a Modern Insurance Store agent. Did you know 🤔 there are over 40+ Medicare plans available this year?

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At The Modern Insurance Store, We offer a wide variety of Medicare Supplement, Medicare Advantage, and Part D plans from all the top companies in Ohio such as UnitedHealthcare/AARP, Anthem Blue Cross and Blue Shield, Aetna, Humana, Cigna, Mutual of Omaha, Silverscript, and many more…

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