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Medicare and HMO

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  • ICNDonna
    Teri, if you have HMO coverage to go with your Medicare, you need to very carefully read your policy. When I first went on Medicare, the HMO I was on would cover only if I went to an "approved" physician --- and if I chose to go outside the plan, I also forfeited my Medicare coverage. The plan I finally chose is one that states simply that if you choose to go outside the plan, I still have my Medicare coverage. I've never used it, but I really need the security of knowing that I can.

    I have little enough to say about what happens to my body that if there's any one place I can have even a little control, that's the route I take.

    So far I've only had one problem with my HMO and that was getting my TMJ surgery approved. But, since nearly all the HMOs refuse to cover TMJ at all, guess I was fortunate that they covered mine.

    I don't really like HMO coverage, but not much in the way of choices with our income. I just wish we had prescription coverage with it.

    Warm hugs,

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  • Teri
    started a topic Medicare and HMO

    Medicare and HMO

    We are going to have to change insurance companies because of the high cost of our current insurance. I was wondering if anyone knows if part B of Medicare will pick up the cost of going to a dr out of network? My primary care dr (who is a total jerk) already told me that he WILL NOT refer me out.

    I've gotten the book from SS but have not been able to understand crap-o-la from it.
    Can anyone help me out with this? I know that they take a payment out of your monthly check to cover the part B but that's about all I know and understand