Medicare HMO


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Managed Care Plan

A Managed Care plan involves a group of doctors, hospitals, and other health care providers who have agreed to provide care to Medicare beneficiaries in exchange for a fixed amount of money from Medicare every month. Managed Care plans include Health Maintenance Organizations (HMOs), HMOs with a Point of Service (POS) option, Provider Sponsored Organizations (PSOs), Preferred Provider Organizations (PPOs), and Cost Plans.

  • Cost
    You pay a $43.80 Part B premium. Some plans charge an extra monthly premium. You may also pay the plan a copayment per visit or service. You will pay more if you don't follow plan rules. No Supplemental Insurance policy is necessary if you join a Managed Care plan.

Providers

  • HMO - You must go to plan doctors and hospitals.

  • HMOs with POS Option - You may use doctors and hospitals outside of the Managed Care plan at an additional cost.
  • PSO - You must go to plan doctors and hospitals.
  • PPO - You may use doctors and hospitals outside of the Managed Care plan at an additional cost.
  • Cost Plans - You may use doctors and hospitals outside of the Managed Care plan. You will pay the coinsurance, deductible, and extra charges that you would normally pay under the Original Medicare plan.

 

Advantages

There are two main advantages associated with managed care plans. The first is low premiums. The second advantage is many managed care plans offer additional benefits not covered under the Original Medicare plan.

Disadvantages

Managed care plans are not very flexible and the covered person has very little say in treatment options. Managed care plans are not guaranteed renewable and many managed care plans have pulled out of areas forcing people to find new coverage.

Although managed care plans are required to provide benefits similar to Medicare not all plans are the same. Shop around on your own compare rates and benefits from several companies to make sure you get a plan that's right for you. It is also very important to choose a company with a excellent rating. For more information and rates on managed care coverage visit our specialist site below.

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