HMO vs Traditional Medicare Part A

johtootie

New Member
What is the difference in HMOs and Traditional Medicare Part A benefits? Which offers the better savings for prescription cost? Which offers the better benefits for long term care services?
 
johtootie said:
What is the difference in HMOs and Traditional Medicare Part A benefits? Which offers the better savings for prescription cost? Which offers the better benefits for long term care services?

Johtootie,

I assume you have in mind Medicare Advantage when you use HMO.
Medicare Advantage are offered by private insurance companies and cover all services that Original Medicare covers (i.e., Part A and Part B) but they some variations in coverage. Typically, they are constrained by plan's network, and still have substantial deductibles, coinsurances and copayments. However, they have Maximum Out-of- Pocket (MOOP), and some extra benefits such as vision/dental/ hearing.
Medicare Part A does not cover prescription drugs, you need to buy Part D separately. Medicare Advantage has an option that includes prescription drug coverage, known as MAPD.

As far as long term care, here is the quote from medicare.gov
"Medicare doesn’t pay for long-term care. Medicare pays only for medically necessary skilled nursing facility or home health care. However, you must meet certain conditions for Medicare to pay for these types of care. Most long-term care is to assist people with support services such as activities of daily living like dressing, bathing, and using the bathroom. Medicare doesn’t pay for this type of care called "custodial care".

Hope this will help.
 

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