How do Medicare Advantage HMO-POS plans work?
HMO-POS plans generally offer you more choice than traditional health maintenance organization (HMO) plans. You typically choose an in-network primary care physician. Most of our HMO-POS plans require you to use a participating provider for medical care. And, most of these plans provide you with flexibility to go to licensed dentists either in or out of our network for routine dental care. However, you may pay more for out-of-network care you receive.
${company} Medicare Advantage plans at a glance
|
Our HMO-POS plans |
Our HMO plans |
Our PPO 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. |
Yes, unless it's an emergency |
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, in most plans |
Yes |
|
Fitness benefit |
Yes, through SilverSneakers® |
Yes, in most plans, 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 most plans |
Yes, in many plans |
Yes, in most plans |
${company} Medicare Advantage plans at a glance
|
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 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 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-POS 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
With many of our HMO plans, an in-network primary care physician coordinates the care you receive to help you achieve your best health.
${company} Medicare Advantage PPO
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 who have both Medicare and Medicaid. We can help you find out if you qualify.
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