With an HMO-POS plan, you must choose a primary care physician (PCP) who will coordinate your care. You must generally get your care from in-network providers, except for emergency care or out-of-area urgent care. However, you may have the option to go out of network for certain services, such as dental care or specialty care. If you do go out of network, you will typically pay more for the services you receive.
HMO-POS plans can be a good option for people who want the affordability and convenience of an HMO, but also want the flexibility to go out of network for certain services.
Here are some of the benefits of Medicare HMO-POS plans:
- Affordability: HMO-POS plans typically have lower monthly premiums and out-of-pocket costs than Original Medicare.
- Convenience: HMO-POS plans offer a one-stop shop for your healthcare needs. You have a PCP who coordinates your care, and you can see other in-network providers without having to get referrals.
- Flexibility: HMO-POS plans give you the flexibility to go out of network for certain services, if needed.
Here are some of the things to keep in mind about Medicare HMO-POS plans:
- You must choose a PCP: You will need to choose a PCP who will coordinate your care.
- You must generally get your care from in-network providers: If you go out of network, you will typically pay more for the services you receive.
- You may have to pay referrals for out-of-network care: If you need to see an out-of-network specialist, you may need to get a referral from your PCP. If you don’t get a referral, you may have to pay the full cost of the service.
If you are considering a Medicare HMO-POS plan, be sure to compare the different plans available in your area and choose the one that best meets your needs. You can also talk to a Medicare insurance agent to get help choosing the right plan for you.