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Medicare Advantage HMO vs. Medicare Advantage PPO

what is medicare hmo

Medicare Advantage is a specific type of Medicare also known as Medicare Part C. The Medicare Advantage plan offers individuals an alternative to Parts A and B. While Medicare Advantage is a Medicare approved program, this health insurance is delivered through private companies.

In order to obtain Medicare Advantage, you’ll need to be entitled to Medicare Part A and enrolled in Medicare Part B. You’ll continue to pay the part B premium and you’ll retain all of your full Medicare rights – but you’ll have additional benefits that aren’t part of your Medicare coverage. Many people opt for Medicare Advantage as it can provide stable costs for dental, vision and alternative care. Since Medicare Parts A and B don’t offer full coverage of all health care needs, getting additional coverage through a Medicare Advantage plan can be a smart move.

Medicare Advantage plans come in two major varieties – HMO plans and PPO plans.

HMO plans. or health maintenance organizations, allow

you to choose from a network of contracted, reliable doctors who work exclusively with your health plan’s members. You’ll choose a primary care physician from the plan network and be referred to specialists within the plan network if you need additional care. In addition to health insurance coverage, Medicare Advantage HMO plans also include prescription drug coverage similar to Medicare Part D coverage.

Many retirees and seniors seek out HMO coverage because of the cost savings. With a Medicare Advantage HMO plan, you’ll be able to have all of the coverage of Medicare Part A and Medicare Part B with your additional benefits for one low monthly premium.

For example, with a Medicare Advantage HMO plan, your coverage may lead to a lower out-of-pocket expense in comparison to the same care covered by a PPO and using an out-of-network provider. Monthly premiums can be higher for PPO plans as well, which can be a problem for Medicare patients on a fixed income.

Category: Insurance

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