Medicare Advantage HMO Plans

With many ${company} Medicare Advantage HMO plans, you typically choose an in-network primary care physician who works with you to help you get the right care at the right time. So you can achieve your best health.

ZIP CODE

How do Medicare Advantage HMO plans work?

A health maintenance organization (HMO) gives you access to a network of doctors and hospitals that you must use in most cases. Some HMO plans require you to get a referral from a primary care physician 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	Yes	Yes
Fitness benefit	Yes, through SilverSneakers®	Yes, through SilverSneakers®	Yes, through SilverSneakers®
Over-the-counter (OTC) benefit	Yes, in many plans	Yes, in many plans	Yes, in many plans
Meals-at-home program (meals delivered after an inpatient hospital or skilled nursing facility stay)	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
Fitness benefit	Yes, through SilverSneakers®
Over-the-counter (OTC) benefit	Yes, in many plans
Meals-at-home program (meals delivered after an inpatient hospital or skilled nursing facility stay)	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 many plans
Meals-at-home program (meals delivered after an inpatient hospital or skilled nursing facility stay)	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 many plans
Meals-at-home program (meals delivered after an inpatient hospital or skilled nursing facility stay)	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.

Learn about HMO-POS plans

${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.

Learn about PPO plans

${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.

Learn about D-SNPs

Questions? We’ve got answers

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Medicare Advantage HMO Plans

How do Medicare Advantage HMO plans work?

${company} Medicare Advantage plans at a glance

${company} Medicare Advantage plans at a glance

Medicare Advantage plans for every need

${company} Medicare Advantage HMO-POS plans

${company} Medicare Advantage PPO plans

${company} Medicare Advantage D-SNPs

Questions? We’ve got answers

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