Optima Medicare HMO
Dean provides its Medicare members comprehensive coverage and access to quality care through a strong network of providers. Learn about the Medicare Advantage plans, Medicare Supplement Insurance plans. HMO: A Health Maintenance Organization (HMO) plan has a network of doctors, hospitals, and providers that you must use to be covered by the plan. These protections will enable beneficiaries, in certain situations, to try a plan, but then return to Original Medicare and a Medicare Supplement policy if they want to do so.
You must live within the service area of the Medicare Advantage plan. HMO Point-of-Service (HMO POS) plans typically require you to choose a primary care doctor and to get a referral from this primary doctor to see a specialist. Another caveat: If you enroll in Medicare Advantage, you may have a hard time getting supplemental Medigap coverage if you later decide you want to switch Medicare Plans 2019 to traditional Medicare.
Typically, one of the most popular Medicare plans nationwide is Medicare Supplement Plan F This particular policy will cover 100% of the major gaps left by Medicare. Many people choose to sign up for a Medicare Advantage plan in addition to Original Medicare because it covers everything Original Medicare covers plus additional benefits.
You must get a referral from your Primary Care Physician to receive care from health care providers outside of the network, or the plan will not pay (unless you are in a PPO or PFFS). Some of the changes will affect all beneficiaries while others will apply just to individuals who select Medicare Advantage plans.
If you go out of your network for care, your insurer might not pay for it. The provider networks are grouped based on ZIP codes or county lines. If you enroll in one of these plans you can also see any of the network providers who've agreed to always treat plan members.
Also, this information is not intended to imply that services or treatments described in the information are covered benefits under your plan. To be eligible to enroll in a Medicare Advantage plan, you must be enrolled in Original Medicare, reside in the plan's service area, and (in most cases) not have end-stage renal disease (ESRD).