Could a Medicare Advantage HMO plan be right for you?

Typically HMO plans offer coverage for in-network providers only, with the exception of urgent and emergency care while out of the area. So if you don't receive routine care out of the area, an HMO plan might be a good fit. You'll also need to designate a primary care physician (PCP) to enroll in an HMO plan.

Check out the Medicare Advantage HMO plans listed below to see which one may best fit your needs.

Compare Plans


2023 Medicare HMO Map

Basic Rx HMO1

Monthly Premium*

$31

Primary Care Physician Office Visit Copayment

$0

Doctor on Demand

$0

Specialist Office Visit Copayment

$35

Routine Annual Physical Exam Copayment

$0

Urgent Care Copayment

$60 worldwide coverage

Emergency Room Copayment2

$90 worldwide coverage

Ambulance

$260

Outpatient Surgery

$280-$330

Physical Therapy

$35

Inpatient Hospitalization

Days 1-6: $315 per day

Dental Reimbursement for All Dental Services
Routine Cleaning/Restorative/Dentures (not for whitenings)

$725 reimbursement

Vision: Annual Routine Eye Exam

$20

Frames/Lenses (per year)

$215 reimbursement

Hearing Care Solutions Hearing Aid Benefit

$599 or $899

Over-the-counter Benefit

$75 / quarter

Senior Fit Included

Yes

CDPHP Life Points® Rewards

Earn up to $175

Lab Services

$0 or $5

X-rays

$35

Advanced Imaging Studies (CT, MRI, etc.)

$140

OOP Max

$6,700

Plan Documents

Evidence of Coverage (EOC) and Summary of Benefits (SOB)

*You must continue to pay your Medicare Part B premium; You may qualify for lower premiums with EPIC or Low Income Subsidy


Disclaimers:

  1. Must use plan providers

  2. Copayment waived if admitted to the hospital within 24 hours for the same diagnosis.