What Is a Medicare HMO Plan?

Updated: Nov 25, 2020

Medicare Advantage plans are private health insurance plans available to seniors who qualify for Medicare. These plans cover Parts A and B of Medicare insurance and typically also include prescription drug coverage and other services such as hearing and dental that Original Medicare does not cover. Medicare Health Maintenance Organization (HMO) Plans are one of four common kinds of Medicare Advantage plans. The other three common types are:

A Medicare agent at PBC can help you learn about whether a Medicare HMO plan is right for you. In this article we’re going to take an overall look at Medicare HMOs and how they work.

How Medicare HMOs work

Like all types of Medicare Advantage Plans, HMOs must provide seniors with the same benefits, rights, and protections as Original Medicare. They are, however, allowed to provide them with different restrictions, rules, and costs. Some HMOs offer extra benefits, such as vision and hearing care. Check with a Medicare Agent for plan details.

Can I join a Medicare HMO?

In order to qualify for a Medicare HMO Plan, you must already be enrolled in Medicare Parts A and B. In most cases, you will continue paying your Medicare Part B premium. Some HMOs pay part of this premium while others may charge an additional premium, on top of your Part B premium. One reason that a plan would charge an additional premium is if it includes prescription drug coverage.