Several types of Medicare Advantage plans are available, and a Health Maintenance Organization (HMO) is one of them. If you join an HMO Plan, you will need to go to your Primary Care Physician (PCP) within the HMO’s network of doctors to get most of the routine care you will need. If you do need to see a specialist, you will need to get a referral from your PCP before you see them; otherwise, those services may not be covered. This process is much easier than it used to be, and most referrals are done electronically, so you don’t have to pick up a paper referral from your PCP’s office. There are some cases when you can receive services from doctors outside the HMO network, including the following:
- Emergency care
- Out-of-area urgent care
- Out-of-area dialysis
There is also a variation of HMO plans called HMO-POS (the POS stands for Point-Of-Service). These plans allow you to go out-of-network for certain services. But, it usually costs more if you go to one of those out-of-network doctors.
