A Medicare HMO (Health Maintenance Organization) is a type of managed care Medicare plan. With an HMO, you choose a primary care physician (PCP) from the plan’s local network. Your PCP oversees your care and coordinates services within that network of doctors and hospitals. When specialty care is needed, your PCP provides a referral.

To enroll in a Medicare HMO plan, you must be enrolled in Medicare Parts A and B and live within the plan’s service area. After enrolling, you are generally required to use in-network providers, except in emergency situations.

• You can enroll in a Medicare HMO during an eligible enrollment period, provided you do not have end-stage renal disease.
• Some plans offer premiums as low as $0, though premiums may change from year to year.
• Care must be received within the plan’s provider network, except for emergencies.
• Many Medicare HMO plans include Part D prescription drug coverage—be sure your medications are covered.
• You’ll typically pay out-of-pocket costs such as copayments or coinsurance when receiving care.
• Review your plan annually, as benefits and costs may change each year and take effect on January 1