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Published:2010/03/10
Arrowhead Health took out billboard advertisement blasting decision to discontinue Medicare.......
Published:2010/03/10
CENTRAL VIRGINIA - The ongoing federal health care debate is playing out in Richmond-area doctors offices. Physicians are wondering if they will be forced to turn away Medicare pat......
Published:2010/03/10
If Congress allows the 21% cut in Medicare payments to physicians then many physicians will choose to stop seeing Medicare patients. The House Clinic has.........
Published:2010/03/10
WASHINGTON—Legislation introduced in the U.S. House would cap penalties and set a three-year statute of limitations for failing to comply with reporting under Section 111 of the ......
Published:2010/03/11
Colorado’s unemployment rate is up one-tenth of a percentage point to 7.4 percent, while the Gazette is reporting unemployment in the Colorado Springs area rose .4 percentage poi......
Health Maintenance Organization (HMO) and Medicare
A Health Maintenance Organization or (HMO) is a Medicare Health Plan that is available throughout most of the United States. An HMO Plan must cover all Medicare Part A and Part B health care. Some HMOs cover extra benefits, like additional days in the hospital.
With most HMOs, you can only go to doctors, specialists, or hospitals that are on the plan's list except in the case of an emergency. There is a possibility that your costs may be lower than in the Original Medicare Plan.
A majority of the HMOs require that you select a primary care physician (PCP). This doctor acts as a "gatekeeper" to direct your access to medical services. PCPs are usually family doctors, pediatricians, internists, or general practitioners.
Unless it is a medical emergency, you need a referral from your PCP in order to see a specialist or other doctor. The gatekeeper cannot authorize that referral unless the HMO guidelines consider the referral necessary.
