Learn all there is to know about insurance.
You can get your Medicare benefits through Original Medicare, or a Medicare Advantage Plan (like an HMO, PPO, PFFS).If you have Original Medicare, the government pays for Medicare benefits when you get them.Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by private companies approved by Medicare.Medicare pays these companies to cover your Medicare benefits.If you join a Medicare Advantage Plan, the plan will provide all of your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage.This is different than a Medicare Supplement Insurance (Medigap) policy.
In most HMOs, you can only go to doctors, other health care providers, or hospitals in the plan’s network, except in an urgent or emergency situation.You may also need to get a referral from your primary care doctor for tests or to see other doctors or specialists.You will need to choose a primary care doctor upon enrolling into most HMO plans, and most of the time this doctor will have to refer you to see a specialist.
Prescription drugs are covered under most HMO plans called Medicare Advantage Prescription Drug plans.Check with the plan you’re interested in first if you want it to include Medicare Part D prescription drug coverage.When you enroll in an HMO, you agree to receive coverage within that plan’s network except in urgent and emergency situations.You can stillreceive health care outside of the plan’s network, but be aware that the plan may not pay for these services.
These are HMO plans that may allow you to get some services out-of-network for a higher copayment or coinsurance.