Will my Health Maintenance Organization plan cover urgent care?
Yes. Your plan may even cover some urgent care received out of network. However, it will be your responsibility to learn if the service provider is inside your network or not.
Can I get non-emergency coverage out of the network?
No, all non-emergency care must be received in-network.
How much does an HMO plan cost?
When compared to other Medicare Advantage plans, HMO plans are one of the more affordable options. Out of pocket expenses for these plans are particularly low. The actual premium amounts will depend on what insurance companies offer in your area. However, our experts at Buffalo Health Advisors know how to ask the right questions to get you the best rates.
When can I sign up for an HMO plan?
If you are eligible for Medicare you can enroll in an HMO plan. Typically, if you are over age 65 or are turning 65, you can join any one of these Medicare Advantage plans.
Open enrollment for standard Medicare begins three months before you turn 65. The enrollment period is open for seven months, which includes the month you turn 65 and the three months after.
If you are below 65, you may join a non-Medicare HMO plan during open enrollment from November to December each year, or anytime you qualify for a special enrollment period.
What is the difference between HMO and PPO plans?
Another plan that resembles the Health Maintenance Organizations is a Preferred Provider Organization (PPO). The main difference between these plans is the range of the network. PPOs reach more physicians than your PCP at no additional cost. However, your costs will always be the lowest when you see a provider that is in-network for both HMOs and PPOs. When you see a provider out of network on a PPO, your health plan will pay a portion of the cost, but probably at a reduced rate, so you will still pay more than you would when seeing your PCP.