Medicare Complete

Medicare Complete plans are typically classified as Health Maintenance Organization (HMO) plans. Even though this is the case, some of these HMO plans offer Point-of-Service (POS) options. Seniors utilizing HMO plans are provided with a list of specific doctors and hospitals from which they may choose to receive medical care. Seniors that prefer an HMO with a POS option are able to choose the doctors and hospitals from which they desire to receive particular types of medical services. This may come at a higher cost to the individual as co-insurance and co-payments may be more expensive, and this can generally be attributed to the doctors or hospitals being considered out-of-network.

Medicare Complete HMO and POS plans offer many of the same benefits as original Medicare, but these plans may also offer additional benefits as well. While offering access to medical care through a network of competent, caring physicians as well as coverage for a variety of preventative services, such as an annual, routine physical exam, these plans may also offer Part D prescription drug coverage and coverage for preventative services related to hearing, dental, and vision. Seniors that choose HMO coverage can expect to continue paying their Medicare Part B premium. Those choosing the HMO plan with the POS option will likely pay a higher premium for this type of coverage.

Specific types of Medicare Complete plans offer seniors the option of a Preferred Provider Organization (PPO) plan rather than an HMO. Those that prefer a PPO plan will still be provided with a list of in-network doctors and hospitals, but individuals have the flexibility of choosing their own doctor or hospital. As with the HMO with a POS option, PPO coverage typically requires the individual to higher out-of-pocket expenses for this type of coverage. Medicare Part D prescription drug coverage and other benefits are offered with PPO plans.

Medicare Complete also offers the special needs plan. This plan is designed for individuals that qualify for both Medicare and Medicaid, have a chronic illness, or live in some type of residential facility or institution. Three types of plans are available with this type of coverage and they include: the low-income plan, the institutional plan, and the disease-specific plan. Individuals utilizing this type of plan will still be eligible for Medicare Part D benefits, including prescription drug coverage, as long as they continue to pay their Medicare Part B premiums.

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