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Medicare Health Maintenance Organization (HMO)

  • If you enroll in a Health Maintenance Organization (HMO) plan, you must obtain services from a designated network of doctors, hospitals and other health care providers who have agreed to provide services for plan enrollees.

  • The plan has a limited service area and you must live within that service area to enroll and not have End Stage Renal Disease (ESRD).

  • Generally, if you receive treatment outside the network of providers, you probably will be responsible forpay the entire bill unless the service is for emergency or urgently needed care.

  • A primary care physician (PCP)controls your access to other services.

  • HMO plans have co-payments for some services.

  • You continue to pay your Part B premium directly to Medicare and pay the plan a premium.