Senior Educators: HMO Plans

Health Maintenance Organizations, or HMOs, are traditional managed care organizations. HMOs have been an option for Medicare recipients for nearly 30 years. The type of coordinated care HMOs provide is seen as particularly useful for the Medicare population. Medicare HMO members report high levels of satisfaction.

How do HMO plans work?

HMOs provide Medical services through a network of doctors and physicians. Most HMOs also provide Medicare Part D prescription drug coverage as part of the plan. By law, HMO plans, like all other Medicare Advantage plans, must be at least as good as Original Medicare.

Which doctors can I see with an HMO?

HMOs restrict which doctors and hospitals you can use for nonemergency care to a provider network. These networks differ by company and even by plan, so it's important to make sure that before you join an HMO, you have checked to make sure your doctor accepts the HMO. In addition, most HMOs require that you see your primary care physician, or regular doctor, before seeing a specialist. It's important to note that in an emergency, however, you can see any Medicare doctor.

How do I choose which plan is right for me?

Many people like help deciding which plan is a good choice for them. Plans vary widely from company to company and from place to place, and when comparing plans between companies it’s important to compare the fine print—not just the premiums. That’s what Senior Educators Insurance Services was created for—to provide free, unbiased assistance to Medicare recipients to help them choose appropriate coverage. To request help now, please fill out the short informational form here so a licensed representative can be well informed about your healthcare preferences. Or simply give us a call at 1-800-236-4613 and speak with a trained and licensed representative now!

If you prefer to do the research by yourself, we’ve created a number of tools to help you do so. First, we have created the Senior Educators Insurance Services’ Top 10 Tips for Navigating Medicare, which captures a very high-level perspective on what to consider based on our years of experience. Second, we have created a plan comparison engine that shows you a list of the plans available in your area. To access that tool, enter your zip code on the side of this page and click the “Find Plans” button. We hope that if you find a plan through our tools, you’ll enroll through our organization, as it’s how we can afford to provide excellent, unbiased information and help.