HMO vs. PPO
HMO and PPO plans are a type of Medicare Advantage plan. HMO plans stand for Health Maintenance Organization plans, while PPO refers to Preferred Provider Organization Plans.
We’ll examine the features and differences between HMO and PPO plans.
HMO Plans
HMO plans are sold by private insurance companies that are approved by Medicare. To enroll for an HMO plan, you must have Original Medicare.
Like other Part C plans, HMO plans cover the same services that Original Medicare covers. Health Maintenance Organization plans often cover additional services such as prescription drug coverage, dental, and vision. HMO plans have a list of in-network healthcare providers that are approved by the plan. This means to get coverage for medical services, you must visit a provider within the network. If you go out-of-network, you may have to cover the full cost. HMO plans only cover out-of-network care if you need dialysis or urgent care when traveling.
HMO plans also require you to get a referral for specialist visits.
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