Last Updated on by

Medicare Advantage HMO Point of Service Options

You are here:

Medicare Advantage HMO point of service plans allows members to freely visit doctors outside of the plan’s network of providers. This includes specialists but the out-of-pocket costs will be higher. Like HMOs, beneficiaries may need to choose a primary care physician to help coordinate care and provide referrals for specialists.

Medicare Advantage HMO Point of Service Plans

Medicare Advantage HMO point of service plans provide extra benefits for members. Offering services like routine dental, vision, and hearing. Some plans offer worldwide urgent and emergency care and even gym memberships.

Plans allow members to receive care outside of the plan’s network, but the cost of care will be more expensive.

An HMO-POS policy has the flexibility of a PPO with restrictions like an HMO. Although, depending on the insurance carrier, policy rules may be different.

HMO-POS plans often have larger provider networks than HMOs. Although, monthly premium costs and copayments for care may also be higher for members.

HMO Point of Service vs PPO

Advantage plans with an HMO-POS include the convenience of having one doctor to coordinate all healthcare needs. Additionally, providing coverage for beneficiaries that do a lot of traveling within the country. Let’s use

Contrarily, PPO plans offer more flexibility than HMOs including HMO-POS policies. For starters, beneficiaries don’t need to choose one primary care physician for the coordination of care. Unlike HMOs, PPOs don’t require referrals to visit with a specialist.

Both HMO-POS and PPO plans allow members to visit with providers inside or outside of the plan’s network. However, the cost will be less when staying inside a plan’s network. Likewise, the cost will be higher when receiving services from an out-of-network physician.

Does HMO POS Plans Pay for Prescriptions?

Prescription drug coverage can be costly, Part D prescription drug plans can help with this expense. In most cases, HMO-POS plans pay for prescriptions. However, beneficiaries must enroll in an HMO plan offering prescription drug coverage.

Medicare Advantage HMO Point of Service Enrollment

Enrolling in a Medicare Advantage or changing plan types like HMO-POS must happen during one of the open enrollment windows. This can include your Initial Enrollment Period, the Medicare Advantage Open Enrollment Period, the Annual Enrollment Period, or a Special Enrollment Period.

We Can Help You Find The Best Policy

Using an agent to determine what type of plan is best for your healthcare needs is the best way to avoid unnecessary out-of-pocket expenses.

Agents can compare rates, provide quotes, and walk you through all the available options for coverage. All with no additional cost to you. Give us a call today at the number above and let us help you!

Don’t have time to call? Fill out a rate comparison form online.

Leave a Reply

Your email address will not be published. Required fields are marked *

Post comment