What is the difference between medicare and medicare hmo?

Question

How does this affect the Dr's cash flow if you submit a claim to medicare but the patient is actually covered under medicare hmo?

Answer 1

Medicare --and the different Medicare plans now on the market --can be very confusing. How you will be affected --whether you are enrolled in traditional Medicare or whether you are enrolled in one of the newer Medicare HMO-type plans-- depends on the plan you have and where you live. There are many variables--especially in the HMO plans!

If you would like some help in answering this question from objective professionals who aren't "selling" a particular plan or product --and how it would work if you are considering changing the plan you have to another one -- I would highly recommend that you contact the Area Agency on Aging where you live. They can also find out the answer to your question about how the claims process would work--or if it works--in the situation you describe

When you talk with the staff person at your Area Agency it would also be helpful if you have details about the plan you currently have. If you have questions about Medicare Part D options, you will also want to have a list of all the prescriptions you are taking the dosages prescribed and also the pharmacy that you prefer to do business with.

Professionals at the Area Agency on Aging can provide guidance in helping seniors and their caregivers deal with the peculiarities of Medicare. You will most likely find the professional staff there friendly and helpful--and they are not selling any particular plan or product. They also know the latest "scoop" on changes that are still happening with Medicare in your state. (Yes! More changes are happening--particularly with Medicare Part D!)

If you live in the United States or one of the territories, there is an Area Agency on Aging serving where you live. You can call toll-free 1-800-677-1116 to find how to contact the one serving you.

If you do contact your local Area Agency on Aging and like the help that they give you, let your local county officials and your folks in Congress know. Area Agencies on Aging are funded under the Older Americans Act and they don't have big budgets for advertising and certainly don't have budgets that support campaign contributions!

Hope this helps! Best wishes!

Answer 2

an hmo means that you dont gt to choose your doctor, the medicare people have to choose one for you, that you have to see. if you did that, then i would think that medicare will reject your claim if you didnt go to the assigned doctor.

Answer 3

Here is a site that I think should answer most of your questions. http://www.medicarerights.org/maincontentpolicyhmomarketing.html

Let me know if this doesn't do it for you. We can look for more again if you like.