A Medicare Advantage HMO plan is similar to major medical HMO plans.
With a Medicare Advantage HMO you are required to use par doctors, hospitals and other medical providers in the HMO network. If you use non-par providers, in most cases, you have no coverage.
Exceptions are made for par provider referrals to non-par providers and for true medical emergency's.
Medicare Advantage HMO, sometimes referred to as Medicare Part C, is available through private insurance carriers that contract with Medicare to provide health insurance for Medicare beneficiaries.
This particular type of HMO usually has very limited networks bound by county or zip code. Most HMO plans only have coverage in network. If you venture outside the network, except for a medical emergency, you have no coverage.
Owner/Insurance Broker, KM Health Insurance Services, Hazel Crest, Illinois
This truly depends on your zipcode as well. Medicare Advantage plans include Hmo, Hmo-Pos, PPO and PFFS plans. Hmo-pos plans work like a ppo in the sense that you have in and out of network benefits(out of network benefit co pays are normally a little higher). Here in Chicago we have many awesome Hmo-Pos plans that not only allow in and out of network benefits but also can include part D, Dental,Vision and other benefits.
.JPG){kind=avatar}
With a Medicare Advantage HMO you are required to use par doctors, hospitals and other medical providers in the HMO network. If you use non-par providers, in most cases, you have no coverage.
Exceptions are made for par provider referrals to non-par providers and for true medical emergency's.
This particular type of HMO usually has very limited networks bound by county or zip code. Most HMO plans only have coverage in network. If you venture outside the network, except for a medical emergency, you have no coverage.