Call us
Talk to a licensed agent at
${dynamicPhone} ${tty}
${hours}.
How do Medicare Advantage HMO plans work?
A health maintenance organization (HMO) gives you access to a network of doctors and hospitals. Your plan requires you to use these network providers in most cases. Some HMO plans require you to get a referral from a PCP for hospital care and specialist visits. There are typically limited out-of-network benefits with an HMO plan.
${company} Medicare Advantage plans at a glance
|
Our HMO plans |
Our HMO-POS plans |
Our PPO plans |
|
|---|---|---|---|
|
Requires you to use a provider network |
Yes, unless it’s an emergency |
Varies by plan. Seeing out-of-network providers generally costs more. But most allow non-network dental providers. |
No. But seeing out-of-network providers generally costs more. |
|
Requires you to have a primary care physician (PCP) |
Yes, in many plans |
Yes, in many plans |
Usually no PCP required |
|
Requires referral to see a specialist |
Some plans |
Some plans |
No referral required |
|
Monthly premiums |
Varies by plan, check your ZIP code for details |
Varies by plan, check your ZIP code for details |
Varies by plan, check your ZIP code for details |
|
Medical deductible |
Varies by plan, check your ZIP code for details |
Varies by plan, check your ZIP code for details |
Varies by plan, check your ZIP code for details |
|
Limits what you pay out-of-pocket for medical care each year |
Yes |
Yes |
Yes |
|
Includes prescription drug (Rx) coverage |
Yes, in most plans |
Yes, in most plans |
Yes, in most plans |
|
Includes Rx mail-order benefit |
Yes, if plan has Rx coverage |
Yes, if plan has Rx coverage |
Yes, if plan has Rx coverage |
|
Dental, vision and hearing coverage |
Yes, in most plans |
Yes, in most plans |
Yes, in most plans |
|
ER and urgent care coverage worldwide |
Yes, in most plans |
Yes |
Yes |
|
Fitness benefit |
Yes, in most plans, through SilverSneakers® |
Yes, through SilverSneakers® |
Yes, through SilverSneakers® |
|
Over-the-counter (OTC) benefit |
Yes, in most plans |
Yes, in most plans |
Yes, in most plans |
|
Meals-at-home program |
Yes, in many plans |
Yes, in most plans |
Yes, in most plans |
${company} Medicare Advantage plans at a glance
|
Our HMO plans |
|
|---|---|
|
Requires you to use a provider network |
Yes, unless it’s an emergency |
|
Requires you to have a primary care physician (PCP) |
Yes, in many plans |
|
Requires referral to see a specialist |
Some plans |
|
Monthly premiums |
Varies by plan, check your ZIP code for details |
|
Medical deductible |
Varies by plan, check your ZIP code for details |
|
Limits what you pay out-of-pocket for medical care each year |
Yes |
|
Includes prescription drug (Rx) coverage |
Yes, in most plans |
|
Includes Rx mail-order benefit |
Yes, if plan has Rx coverage |
|
Dental, vision and hearing coverage |
Yes, in most plans |
|
ER and urgent care coverage worldwide |
Yes, in most plans |
|
Fitness benefit |
Yes, in most plans, through SilverSneakers® |
|
Over-the-counter (OTC) benefit |
Yes, in most plans |
|
Meals-at-home program |
Yes, in many plans |
|
Our HMO-POS plans |
|
|---|---|
|
Requires you to use a provider network |
Varies by plan. Seeing out-of-network providers generally costs more. But most allow non-network dental providers. |
|
Requires you to have a primary care physician (PCP) |
Yes, in many plans |
|
Requires referral to see a specialist |
Some plans |
|
Monthly premiums |
Varies by plan, check your ZIP code for details |
|
Medical deductible |
Varies by plan, check your ZIP code for details |
|
Limits what you pay out-of-pocket for medical care each year |
Yes |
|
Includes prescription drug (Rx) coverage |
Yes, in most plans |
|
Includes Rx mail-order benefit |
Yes, if plan has Rx coverage |
|
Dental, vision and hearing coverage |
Yes, in most plans |
|
ER and urgent care coverage worldwide |
Yes |
|
Fitness benefit |
Yes, through SilverSneakers® |
|
Over-the-counter (OTC) benefit |
Yes, in most plans |
|
Meals-at-home program |
Yes, in most plans |
|
Our PPO plans |
|
|---|---|
|
Requires you to use a provider network |
No. But seeing out-of-network providers generally costs more. |
|
Requires you to have a primary care physician (PCP) |
Usually no PCP required |
|
Requires referral to see a specialist |
No referral required |
|
Monthly premiums |
Varies by plan, check your ZIP code for details |
|
Medical deductible |
Varies by plan, check your ZIP code for details |
|
Limits what you pay out-of-pocket for medical care each year |
Yes |
|
Includes prescription drug (Rx) coverage |
Yes, in most plans |
|
Includes Rx mail-order benefit |
Yes, if plan has Rx coverage |
|
Dental, vision and hearing coverage |
Yes, in most plans |
|
ER and urgent care coverage worldwide |
Yes |
|
Fitness benefit |
Yes, through SilverSneakers® |
|
Over-the-counter (OTC) benefit |
Yes, in most plans |
|
Meals-at-home program |
Yes, in most plans |
Medicare Advantage plans for every need
In addition to HMO plans, ${company} offers you other Medicare Advantage plan options — some with a $0 monthly plan premium. We can help you find a plan that’s right for you.
${company} Medicare Advantage HMO-POS plans
With our HMO-POS plans, you can enjoy all the benefits of receiving medical care through a network provider. Most of our HMO-POS plans require you to use a network provider for medical care but provide you with flexibility to go to licensed dentists in or out of network for routine dental care.
${company} Medicare Advantage PPO plans
With our preferred provider organization (PPO) plans, you can visit providers, in or out of network, who accept Medicare and ${company}'s plan terms. The freedom is yours.
${company} Medicare Advantage D-SNPs
Our dual-eligible Special Needs Plan (D-SNP) is a type of Medicare Advantage plan, available to people living in our service area who have both Medicare and Medicaid. We can help you find out if you qualify.
Questions? We’ve got answers
Medicare FAQs
Get answers to common Medicare questions.