One of the most popular Medicare Advantage plans is the Health Maintenance Organization (HMO) plan. This plan will provide you with the same coverage as Original Medicare. It can also provide you with additional benefits, such as prescription drug coverage.
Besides prescription drug coverage, other additional benefits can include:
- Dental coverage
- Vision coverage
- Hearing coverage
- Gym memberships
- Adult day-care services
- Nutrition and wellness programs
- Transportation to doctor’s offices
How Do HMO Plans Work?
HMO plans will require that you use their in-network providers to receive your care. There are a few exceptions to this, though, such as:
- If you need emergency care
- If you need out-of-area urgent care
- If you need out-of-area dialysis
You must also choose a primary care doctor from their network, and get referrals from this doctor to see a specialist. Due to these plans requiring you to use their network providers, you will pay much less out-of-pocket.
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Enrolling in PPO Plans
There are certain times when you can join a Medicare Advantage PPO plan:
Initial Enrollment Period (IEP)
This period starts three months before you turn 65 and then ends three months after you turn 65. You can enroll in Original Medicare, a Medicare Advantage, or Part D plan during this period. Keep in mind you must first be enrolled in Original Medicare before you can join a Medicare Advantage plan.
Annual Enrollment Period (AEP)
If you’re already enrolled in Medicare, this period gives you the opportunity to review your Medicare coverage each year and make changes if necessary. You can switch, drop, or enroll in new plans.
Medicare Advantage Open Enrollment Period
You can switch from one Medicare Advantage plan to another during this period. Or, you can end it to return to Original Medicare.
Special Enrollment Period
You can also enroll in Medicare during the Special Enrollment Period if you missed your Initial Enrollment Period because of a special circumstance. If you enroll during this period, you won’t have to pay late enrollment penalties. Special circumstances include already having creditable health coverage during the time you first became eligible for Medicare.
Need an HMO Plan? Give Us a Call
If you’re ready to go over your HMO plan options and find one that meets your coverage needs, give the Medicare Specialists a call today.