What is an hmo pos health plan

How do Medicare Advantage HMO-POS plans work?

HMO-POS plans generally offer you more choice than traditional health maintenance organization (HMO) plans. You typically choose an in-network primary care physician. Most of our HMO-POS plans require you to use a participating provider for medical care. And, most of these plans provide you with flexibility to go to licensed dentists either in or out of our network for routine dental care. However, you may pay more for out-of-network care you receive.

${company} Medicare Advantage plans at a glance

Our HMO-POS plans

Our HMO plans

Our PPO plans

Requires you to use a provider network

Requires you to have a primary care physician (PCP)

Requires referral to see a specialist

Monthly premiums

Medical deductible

Limits what you pay out-of-pocket for medical care each year

Includes prescription drug (Rx) coverage

Includes Rx mail-order benefit 

Dental, vision and hearing coverage

ER and urgent care coverage worldwide

Fitness benefit

Over-the-counter (OTC) benefit

Meals-at-home program 
(meals delivered after an inpatient hospital or skilled nursing facility stay)

Varies by plan. Seeing out-of-network providers generally costs more. But most allow non-network dental providers.

Yes, unless it's an emergency

No. But seeing out-of-network providers generally costs more.

Yes, in many plans

Yes, in many plans

Usually no PCP required

Some plans

Some plans

No referral required

Varies by plan, check your ZIP code for details

Varies by plan, check your ZIP code for details

Varies by plan, check your ZIP code for details

Varies by plan, check your ZIP code for details

Varies by plan, check your ZIP code for details

Varies by plan, check your ZIP code for details

Yes

Yes

Yes

Yes, in most plans

Yes, in most plans

Yes, in most plans

Yes, if plan has Rx coverage

Yes, if plan has Rx coverage

Yes, if plan has Rx coverage

Yes, in most plans

Yes, in most plans

Yes, in most plans

Yes

Yes, in most plans

Yes

Yes, through SilverSneakers®

Yes, in most plans, through SilverSneakers®

Yes, through SilverSneakers®

Yes, in most plans

Yes, in most plans

Yes, in most plans

Yes, in most plans

Yes, in many plans

Yes, in most plans

${company} Medicare Advantage plans at a glance

Our HMO-POS plans

Requires you to use a provider network

Requires you to have a primary care physician (PCP)

Requires referral to see a specialist

Monthly premiums

Medical deductible

Limits what you pay out-of-pocket for medical care each year

Includes prescription drug (Rx) coverage

Includes Rx mail-order benefit 

Dental, vision and hearing coverage

ER and urgent care coverage worldwide

Fitness benefit

Over-the-counter (OTC) benefit

Meals-at-home program 
(meals delivered after an inpatient hospital or skilled nursing facility stay)

Varies by plan. Seeing out-of-network providers generally costs more. But most allow non-network dental providers.

Yes, in many plans

Some plans

Varies by plan, check your ZIP code for details

Varies by plan, check your ZIP code for details

Yes

Yes, in most plans

Yes, if plan has Rx coverage

Yes, in most plans

Yes

Yes, through SilverSneakers®

Yes, in most plans

Yes, in most plans

Our HMO plans

Requires you to use a provider network

Requires you to have a primary care physician (PCP)

Requires referral to see a specialist

Monthly premiums

Medical deductible

Limits what you pay out-of-pocket for medical care each year

Includes prescription drug (Rx) coverage

Includes Rx mail-order benefit 

Dental, vision and hearing coverage

ER and urgent care coverage worldwide

Fitness benefit

Over-the-counter (OTC) benefit

Meals-at-home program 
(meals delivered after an inpatient hospital or skilled nursing facility stay)

Yes, unless it's an emergency

Yes, in many plans

Some plans

Varies by plan, check your ZIP code for details

Varies by plan, check your ZIP code for details

Yes

Yes, in most plans

Yes, if plan has Rx coverage

Yes, in most plans

Yes, in most plans

Yes, in most plans, through SilverSneakers®

Yes, in most plans

Yes, in many plans

Our PPO plans

Requires you to use a provider network

Requires you to have a primary care physician (PCP)

Requires referral to see a specialist

Monthly premiums

Medical deductible

Limits what you pay out-of-pocket for medical care each year

Includes prescription drug (Rx) coverage

Includes Rx mail-order benefit 

Dental, vision and hearing coverage

ER and urgent care coverage worldwide

Fitness benefit

Over-the-counter (OTC) benefit

Meals-at-home program 
(meals delivered after an inpatient hospital or skilled nursing facility stay)

No. But seeing out-of-network providers generally costs more.

Usually no PCP required

No referral required

Varies by plan, check your ZIP code for details

Varies by plan, check your ZIP code for details

Yes

Yes, in most plans

Yes, if plan has Rx coverage

Yes, in most plans

Yes

Yes, through SilverSneakers®

Yes, in most plans

Yes, in most plans

Medicare Advantage plans for every need

In addition to HMO-POS plans, ${company} offers you other Medicare Advantage plan options — some with a $0 monthly plan premium. We can help you find a plan that’s right for you.

${company} Medicare Advantage HMO

With many of our HMO plans, an in-network primary care physician coordinates the care you receive to help you achieve your best health.

Learn about HMO plans

${company} Medicare Advantage PPO

With our preferred provider organization (PPO) plans, you can visit providers, in or out of network, who accept Medicare and ${company}’s plan terms. The freedom is yours.

Learn about PPO plans

${company} Medicare Advantage D-SNPs

Our dual-eligible Special Needs Plan (D-SNP) is a type of Medicare Advantage plan, available to people who have both Medicare and Medicaid. We can help you find out if you qualify.

Learn about D-SNPs

Call us

What is difference between HMO and POS?

What is the difference between an HMO and POS? Members have to receive in-network care for both POS and HMO plans and both types of plans have restricted networks. They're different in one key way: POS plans don't require referrals to see specialists, but HMO plans demand a referral to see a specialist.

What is the difference between a POS and PPO plan?

In general, the biggest difference between PPO vs. POS plans is flexibility. A PPO, or Preferred Provider Organization, offers a lot of flexibility to see the doctors you want, at a higher cost. POS, or Point of Service plans , have lower costs, but with fewer choices.

What is a disadvantage of a POS plan?

POS plans have higher monthly premiums than HMO plans. POS plans impose a deductible that must be met before coverage is provided for care from out-of-network providers. With a POS, you need to prepare and submit paperwork for claims with out-of-network providers.

What does POS stand for in health insurance?

A type of plan in which you pay less if you use doctors, hospitals, and other health care providers that belong to the plan's network. POS plans also require you to get a referral from your primary care doctor in order to see a specialist.

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