Medicare HMO Advantage Plans provide low-cost advantages.
Medicare is a government-subsidized health insurance program for people aged 65 or older. And while traditional Medicare plans help to cover hospital and outpatient costs, participants can still end up paying substantial out-of-pocket costs. In most cases, Medicare HMO Advantage plans offer advantages in terms of lower costs, coordinated care and additional coverages.
Lower Costs
HMO Advantage plans, also known as Medicare Health Maintenance Organization Advantage Plans, differ from traditional Medicare in that private insurance companies administer HMO plans, whereas the federal government administers traditional plans. And while Advantage plans cover the same treatments and services as traditional plans, private insurers can charge lower costs because of how HMO plans are structured. HMO plan structures provide a managed treatment approach to care that's designed to eliminate unnecessary costs and services, according to Medicare.gov. In reducing unnecessary costs and services, HMO Advantage plan participants pay lower premium rates than those charged by traditional Medicare plans. And while insurance rates and coverages vary from state to state, required co-pay and deductible amounts under HMO Advantage plans typically run lower than those for traditional plans.
Coordinated Care
HMO plans operate within an assigned network of service providers, according to Medicare.gov. This means participants receive treatment, services and supplies from within a designated group of hospitals, doctors and agencies. This kind of plan structure acts as a continuum of care that's designed to provide patients with a coordinated treatment approach. In doing so, duplicate or overlapping services, such as testing or primary care services, are avoided. In effect, the primary care physician coordinates any treatments, services or referrals made on a patient's behalf. As a result, each service provider within the network has a clear understanding of a patient's history and can carry out their assigned role within the treatment continuum.
Full Part A & B Coverage
Traditional Medicare plans have two parts, one for hospital care, or Part A, and one for outpatient care, or Part B. As of 2011, plan participants pay a $1,132 deductible before Part A benefits kick in and a $162.00 deductible before Part B benefits kick in, according to Medicare.gov. Individuals who have HMO Medicare Advantage coverage don't have to pay these deductible requirements as they're already covered by the plan. Participants typically have to pay monthly premium amounts for an Advantage plan in addition to the required monthly premium for Medicare Part B. HMO Advantage plans may also offer additional coverages not covered by traditional Medicare, such as prescription drug coverage as well as additional coverage for hospital stays that exceed the limits set by traditional Medicare.
Tags: traditional Medicare, according Medicare, Advantage plans, Medicare Advantage, Medicare plans, traditional plans
