Are HMO’s More Convenient Than Medigap Insurance?

Medigap insurance plans and HMOs that offer Medicare coverage often compete with each other for business. The consumer may wonder which plan is more convenient. The answer depends on how much coverage an HMO offers and how many doctors take the HMO plans.

Medicare usually contracts with these companies to provide flat-fee services. The HMO makes a profit by seeing patients as little as possible. A managed care plan may have additional benefits that Medicare does not.

Why Choose an HMO Over Medigap Insurance

HMOs often offer more coverage than Medicare does, including preventative plans. This may include dental care, vision screens, and regular physicals required by the patient. The HMOs frequently put limits on this care.

HMOs do not always cover Medicare Part B premiums. If a plan does not cover the cost of Medicare Part B, the premiums will be deducted from the recipient’s social security check. If a person does not travel much and has a wide selection of doctors in the plan, an HMO might make a better choice than traditional coverage.

Disadvantages of Using an HMO Over Medigap Insurance

HMOs try to limit its expenses by making sure that doctors see their patients as little as possible. The insurance may not be ideal for a person who does a lot of traveling. A person cannot see a doctor who is outside of his coverage area if a medical need arises. Technically, he can but he must pay all the costs associated with the doctor’s visit.

While the HMO might cover more parts than Medicare Part A and B, there is no guarantee that it will do so. For many patients, having Medigap insurance is far more convenient than purchasing a Part C plan through a health maintenance organization. Supplemental insurance programs will cost slightly more than an HMO, but the difference in out-of-pocket expenses is small.

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