Medicare Advantage plans are insurance policies sold by private companies which include the base coverages offered by Original Medicare (Parts A and B) with additional benefits added on. Essentially, Advantage policies are enhanced Medicare plans which beneficiaries, who choose to forgo the federally-funded public plan, may purchase privately.
A Medicare Advantage Health Maintenance Organization (HMO) plan typically offers broad coverages, but require beneficiaries to stay within a recommended network of providers. Such HMO Medicare plans can be purchased from companies like Humana, Aetna, and Blue Cross Blue Shield.
This article reviews some of the largest Medicare HMO plans, including Blue HMO, Humana HMO, and Aetna HMO plans.
HMO Humana Medicare Plan
Humana Medicare offers a standard Health Maintenance Organization Medicare Advantage plan it calls Humana Gold Plus HMO. This HMO Humana plan offers the following benefits:
- lower out-of-pocket costs than the other Humana Medicare Advantage offerings
- a large network of health providers
- prescription drug coverage which meets or exceeds the coverage offered by Medicare Part D
- copayment options which are lower than any other Humana plan
- emergency coverage worldwide
- free screenings for most annual checkups
As with any HMO Medicare policy, beneficiaries are required to stay within the required network of health care providers, which is one reason why this plan is less expensive than the company's other options. For more information on rates, visit Humana's website or call 1-800-457-4708.
Blue HMO Medicare Plans
Blue Cross Blue Shield, which offers health insurance via a number of local affiliates in various states, offers Blue HMO policies in all of its various coverage areas. The plan detailed here is gleaned from its Florida HMO offering.
The Blue HMO Medicare plan offers the following general benefits:
- a broad network of doctors and health care professionals
- no copayments for primary care doctors
- low copayments for most specialists
- emergency care available across the United States
- free preventative care
The Blue HMO plans are the least expensive Medicare Advantage policies offered by Blue Cross Blue Shield, primarily because beneficiaries must stay within the recommended network of providers. For more information on rates, visit any BCBS website.
HMO Aetna Medicare
Aetna Medicare offers a national HMO Aetna Advantage plan which offers the following benefits:
- predictable copayments
- a large network of providers from which to choose
- coverage for a large percentage of prescription drugs
- no copayments for preventative care
- vision and hearing coverage (limited)
The HMO Aetna offering is the least expensive of the company's Advantage brands, primarily because (as with all Medicare HMO plans) beneficiaries are required to stay within the company's assigned network of providers.
For more information on HMO Aetna, visit the company's website or call 1-800-529-5586.
Medicare HMO Plans – Benefits
While Medicare HMO plans require beneficiaries to stay within provider networks, thus limiting the primary care providers and specialists available, HMO plans are often the least expensive Medicare Advantage option offered by private insurance companies.
In addition, such plans offer expanded prescription drug and other coverages not provided by Original Medicare. Beneficiaries who need expanded coverage, and can afford to purchase a private policy, are encouraged to compare the various plans available, including HMO Humana, HMO Aetna, and Blue HMO plans.
While the normal enrollment period for Medicare HMO plans is from November 15 to December 31 annually, beneficiaries can apply for special enrollment during the year to attain coverage outside of those dates.
David Harris-Gershon - David Harris-Gershon – a blogger for Tikkun magazine and a freelance writer on Israel, the Middle East and America’s role in ...
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