a contracted health maintenance organization that enrolls Medicare patients and provides benefits to them, instead of traditional Medicare. Patient may enroll and withdraw from HMO's at any time. The HMO and not the DMERC processes claims.
a commercial health plan who has contracted with Medicare to provide the same benefits that Medicare offers and in some cases they provide more
a managed care plan with a network obtained from the professionals and facilities that are part of the plan
an organization that contracts with the government and is paid by Medicare to finance all Medicare-covered health care services for people who enroll in the HMO
a private health plan and joining one will have a great impact on how you get your health care
An HMO that has contracted with the federal government under the Medicare Advantage program (formerly called Medicare+Choice) to provide health benefits to persons eligible for Medicare who choose to enroll in the HMO, instead of receiving their benefits through the traditional Medicare fee-for-service program.
A managed care plan coordinated through the federal Medicare program.
also referred to as Medicare + Choice Plan. This is an HMO for seniors (generally persons over the age of 65) and people on disability. The HMO benefits replace a patient's Medicare benefits, and often cover services that Medicare would not (e.g., pharmacy benefits). A monthly premium may be charged by the Medicare + Choice Plan to the member for these enhanced benefits.
A Medicare-managed care or "Medicare + Choice" option in which members are typically required to receive their care from physicians, hospitals and long-term care facilities that participate in that particular HMO plan.