Medicare HMO Costs & Benefits

A Medicare HMO is a viable option for those who wish to limit their out of pocket medical expenses. It should be known that not all parts of the United States have Medicare HMO benefits as an option. Generally, the more urban areas and areas that have a higher concentration of Medicare eligible residents will have one or multiple Medicare HMOs as an option. The Medicare HMO is a type of Medicare Advantage plan.

Medicare HMO benefits are generally free of charge with no monthly premiums. One would still have to pay the monthly expense of the Medicare part B premium which is $96.40 in 2010.

Medicare HMO benefits are simple and easy to understand. The Medicare HMO will claim that they provide preventive healthcare that focuses on maintaining your health but the fact is that when a Medicare HMO member gets sick he or she will simply go to the doctor and have minimal out of pocket costs.

Here is an example of some of the benefits of a Medicare HMO

• Low or no monthly health plan premiums with minimal co-pays

• A selection of doctors and specialists at minimal co-pays
• A network of hospitals
• Prescription drug coverage benefits
• Additional benefits like dental, vision and hearing care
• Preventive care for prostate screening, mammograms & bone density screening
• Worldwide emergency coverage

Different markets in the United States have varying reimbursement rates from the federal government. The reimbursement rate is the amount of money that the government pays the Medicare HMO company on a monthly basis for each member on the company's membership rolls. A Medicare HMO member is generally confined to receiving medical care to the network of doctors and hospitals on the Medicare HMO network. In addition, the member will be assigned a primary care physician (PCP) who will manage the patient's benefits and refer the member to a specialist if needed.

In very competitive and well reimbursed Medicare markets, such as South Florida, there are numerous Medicare HMO's competing to entice the Medicare recipient to join their plan and numerous additional benefits are offered. If a low cost alternative to Medicare supplement is desired, it is a good idea to analyze the various Medicare HMO benefits in the local market to choose the company that is most beneficial to you.

Please feel comfortable contacting our knowledgable staff for information and expertise.