Medicare 101: Understanding HMO Plans
As a leading provider of health care services, we often receive questions from our patients about Medicare. As an owner of MyTruAdvantage Medicare Advantage Plan, we created this Medicare 101 series to help provide helpful information about options available to you when it comes to your health care coverage.
Understanding HMO plans
A Medicare Advantage HMO plan can be a great option for those looking for a primary care provider (PCP) to help coordinate their care and don’t mind staying within the plan’s network when selecting providers—and the lower costs that come with it.
What is an HMO plan?
An HMO (health maintenance organization) plan is a Medicare Advantage plan offered by approved private insurers, like Deaconess’ own MyTruAdvantage
plan. An HMO plan, like the MyTruAdvantage Select (HMO) plan, covers everything that Original Medicare covers (Part A & Part B) and offers additional benefits typically included in Medicare Advantage plans, like prescription coverage, dental, vision and hearing coverage, gym memberships and more.
One aspect of an HMO plan that makes it different from other types of Medicare Advantage plans is the importance of network
. Here are a few key details to consider when deciding if an HMO plan is right for you.
Staying within your network
With an HMO plan, members choose a primary care provider (PCP) from within the plan’s network. Your PCP will help coordinate your care and can refer you to specialists, when needed. The PCP provides general medical care, helps coordinate care to make sure members get the services they need, and provides referrals to specialists when needed.
It’s important to note that an HMO plan may not cover non-emergency care received from providers outside the network or may have higher costs for out-of-network care. So, you’ll want to check the plan’s network before selecting a provider and receiving care. Emergency care and urgently-needed services are usually covered, however, allowing you receive care when you need it most.
Members with an HMO plan typically select from a network of providers who have agreed to preset costs for providing care. These cost savings are then passed on to the member through low monthly premiums, copays and deductibles.
Some plans, like the MyTruAdvantage Select (HMO) plan, even offer $0 monthly premiums and medical deductibles. And members usually pay a low copayment for covered health care services after meeting any deductible.
Is an HMO plan right for you?
An HMO plan can be a good option for you if your preferred providers are in the plan’s network and you want to have a PCP help coordinate your care. Plus, with additional benefits not covered by Original Medicare, including prescription coverage, dental, hearing and vision coverage, as well as extras like gym memberships, OTC allowances and more, a HMO plan like MyTruAdvantage Select (HMO) plan offers you the coordinated care and benefits you need, at a price you can afford.
Have questions? Need help?
For more help deciding if an HMO plan is right for you, or to review additional plan options, give Deaconess’ own Medicare Advantage plan, MyTruAdvantage
, a call. They’re based right here in Indiana and are ready to answer your Medicare questions—and help you choose the plan that’s right for you.
(833) 213-6731 (TTY 711)
About MyTruAdvantage—Deaconess’ Medicare Advantage plan
MyTruAdvantage is a Medicare Advantage plan founded by doctors and hospitals you know and trust, focused on the community and designed around you. As an owner of MyTruAdvantage, we are pleased to offer this Indiana-based Medicare Advantage plan to our patients, neighbors and community.
To learn more, visit www.MyTruAdvantage.com
or call (833) 213-6731 (TTY: 711).
While Deaconess is affiliated with MyTruAdvantage, we also participate with a variety of other Medicare Advantage Plans operating within the area.