Medicare Health Maintenance Organizations (HMOs) are private companies that are paid by the federal government to provide individuals with Medicare-covered health benefits. Some HMOs offer additional benefits such as vision and hearing care. Medicare HMOs must cover all Medicare-covered services.
If you join a Medicare HMO, you still have Medicare rights and protections.
You must have both Medicare Part A and Part B to join, and generally must continue to pay your Medicare Part B monthly premium. Some Medicare HMOs will pay part of your Part B premium. You cannot join most Medicare HMOs if you have End-Stage Renal Disease (ESRD) unless it is a "Special Needs Plan" that specifically accepts people with ESRD. (If you were already in an HMO when you developed ESRD, you can stay in that plan. If that HMO leaves your area, you can join another HMO in your area.)
You can also get your Medicare prescription drug benefits (Part D) through a Medicare HMO.
To learn more about Medicare prescription drug coverage, click on the links in the GO TO box.
Medicare HMOs are not available to people who live in certain areas. Call your State Insurance Department or State Health Insurance Assistance Program (SHIP) to find out if there is an HMO in your area.
To get contact information for your SHIP, call 800-MEDICARE or click on the link in the LINKS box. To get contact information for your State Insurance Department, click on the link in the LINKS box.