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Published:Tue, 31 Aug 2010 17:13:27 -0700
Medicare sets a Nov. 17 meeting to discuss Dendreons Provenge, but the focus will be on which patients should get the prostate cancer vaccine, not whether to cover it at all.......
Published:Wed, 01 Sep 2010 15:51:15 -0700
Beginning next year, Medicare will pay for tobacco cessation counseling for all tobacco users covered by the federal benefit program. Under the recently enacted Patient Protection......
Published:Wed, 01 Sep 2010 05:21:44 -0700
The State of Florida is near the top in Medicare fraud. I did not realize just how prevelent it is until I had to call about hospital bills I was .........
Published:Tue, 31 Aug 2010 23:38:39 -0700
Recent calls to the Better Business Bureau from senior citizens point to individuals or companies using the Medicare rebate as a tool to gain appointments and get information from......
Published:Tue, 31 Aug 2010 11:23:26 -0700
For those of us in our 50s and 60s, age 65 looks like goalpost shining in the sun. At 65, you are eligible for Medicare and can set aside worries about the cost of health care. Bu......
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.
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