Medicare Advantage HMO plans: What are they and how they can help you save money

Comparing and evaluating plan benefits is an important part of the Medicare journey. But finding a plan that meets your unique health care needs and fits within your budget can be tricky.

Offering numerous benefits at a low cost, a Medicare Advantage Health Maintenance Organization (HMO) plan might be what you’re looking for. But what is an HMO plan, and how can it offer additional benefits while costing less than other types of Medicare plans?¹ This article will explore HMO plans and provide tips for finding in-network providers.

An HMO is a type of health plan that emphasizes affordability by contracting with local doctors, specialists and clinics to create a “provider network”. Care received within the provider network is referred to as “in-network". Care received outside of the provider network is considered “out-of-network". While care from out-of-network providers is not covered by most HMO plans, care received from in-network providers tends to be more affordable compared to other Medicare plans that cover both in-network and out-of-network care.²

While Medicare Advantage HMO plan members must select in-network providers, they may find comfort in knowing that contracted providers agree to meet certain quality standards. Some plans may also require members to be referred by their primary care provider before seeing a specialist, but the costs for approved services may be lower than they would be on other plans. Most UnitedHealthcare non-special needs HMO plans use a national network³ of more than 1.3 million professionals offering access to in-network care across the country.

Working with providers to set rates helps keep plan costs low. Because of this, HMO plans are some of the most affordable options for those on Medicare.

Most Medicare Advantage HMO plans have a $0 monthly premium, while others have a premium in exchange for lower costs when you receive care. Plan members may pay a copayment (copay) or coinsurance for covered services after meeting a deductible, if the plan has one.

Whether you’re an existing UnitedHealthcare Medicare plan member or researching our plan options, use our provider search tool to find a network doctor. Remember to check the provider network before seeking care to help avoid out-of-network costs.