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Helping you get the care you need

With most ${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.

Woman sitting inside

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. Most 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

No. But seeing out-of-network providers generally costs more.

No. But seeing out-of-network providers generally costs more.

Requires you to have a Primary Care Physician (PCP)

Most plans

Some plans

No PCP required

Requires referral to see a specialist

Most plans

Some plans

No referral required

Monthly premiums

Varies by plan from $0-$167

Varies by plan from $0-$37

Varies by plan from 
$0-$204

Medical deductible

Varies by plan from $0-$1,000

Varies by plan from $0-$500

Varies by plan from 
$0-$1,600

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

Yes, in most plans

Includes Rx mail-order benefit 

Yes, if plan has Rx coverage

Yes

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 (get select OTC items at no charge)

Yes, in most plans

Yes

Yes, in most plans

Transportation benefit (trips to things like doctor appointments)

Available in some plans

Available in some plans

Available in some plans

Meals-at-home program 
(meals delivered to your home after a hospital stay)

Available in some plans

Available in some plans

Available in some 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)

Most plans

Requires referral to see a specialist

Most plans

Monthly premiums

Varies by plan from $0-$167

Medical deductible

Varies by plan from $0-$1,000

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 (get select OTC items at no charge)

Yes, in most plans

Transportation benefit (trips to things like doctor appointments)

Available in some plans

Meals-at-home program 
(meals delivered to your home after a hospital stay)

Available in some plans

Our HMO-POS 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)

Some plans

Requires referral to see a specialist

Some plans

Monthly premiums

Varies by plan from $0-$37

Medical deductible

Varies by plan from $0-$500

Limits what you pay out-of-pocket for medical care each year

Yes

Includes prescription drug (Rx) coverage

Yes

Includes Rx mail-order benefit 

Yes

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 (get select OTC items at no charge)

Yes

Transportation benefit (trips to things like doctor appointments)

Available in some plans

Meals-at-home program 
(meals delivered to your home after a hospital stay)

Available in some 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)

No PCP required

Requires referral to see a specialist

No referral required

Monthly premiums

Varies by plan from 
$0-$204

Medical deductible

Varies by plan from 
$0-$1,600

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 (get select OTC items at no charge)

Yes, in most plans

Transportation benefit (trips to things like doctor appointments)

Available in some plans

Meals-at-home program 
(meals delivered to your home after a hospital stay)

Available in some plans

Medicare Advantage plans for every need

In addition to HMO plans, ${company} offers you other Medicare Advantage plan options — many with a $0 monthly plan premium. We can help you find a plan that’s right for you.

Disclaimers

${company} Medicare is a PDP, HMO, PPO plan with a Medicare contract. Our SNPs also have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal.

See Evidence of Coverage for a complete description of plan benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by service area.