My medicare HMO is discontinuing their operations. What are my options for coverage?

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Asked October 8, 2013

1 Answer

Medicare Advantage plans are an HMO alternative to traditional fee-for-service Medicare, often managed by private corporations. If your insurance provider is getting out of the health care insurance business, you have a couple of current options and the potential to have even more when Obamacare goes into effect at the end of the year. The Medicare website also offers a plan finder tool that will help you find a replacement Medicare plan.

Your first option is to switch to the original Medicare plan. It is a fee-for-service type of plan, so you'll have to pay a deductible and per-visit copays, but you will be able to continue getting treatment for your medical needs. By switching to this type of plan, you are also keeping the right to see the same doctors you have been seeing all along, but you will have to pay any differences in cost between network and out of network physicians.

You could also switch to another HMO type of Medicare plan. Just because one insurer has gotten out of the business does not mean that you cannot get coverage, it simply means that you have to seek coverage from a new provider. The drawback here is that unless your doctors are in the same network, you will have to see all new caregivers or pay for the services out of pocket.

As Obamacare goes into effect towards the end of 2013, you will be able to sign up for coverage through a variety of providers, using the proposed health insurance exchanges. You will either have to pay for the coverage yourself or use vouchers if your income is low enough to qualify for them. The exact details of how the Affordable Care Act will work are still being ironed out, but the system is scheduled to go into effect during final quarter of 2013.

Answered October 8, 2013 by Anonymous

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