Yes, as long as the physician that you choose accepts your managed care plan. You may verify that the doctor you choose accepts your insurance by calling your doctor's office, visiting the physician’s profile on this web site, calling AccessMD or calling your doctor’s office.

Participants with Medicare and/or Medicaid authorize Total Community Care to provide services to you. This means that you maintain benefits covered by Medicare and/or Medicaid and become eligible for additional benefits offered by Total Community Care. Individuals who are currently enrolled in an HMO will disenroll in order to join Total Community Care. Our participants live in their own homes, with family members, in assisted living, or in adult family homes.

HMO (Health Maintenance Organizations) plans typically enable members to have lower out-of-pocket healthcare expenses. As a HMO member, you choose a primary care physician (PCP) at the time of enrollment. The PCP will handle most of your healthcare needs. The member must receive a referral from their PCP in order to see a specialist. HMO plans offer a broader range of preventive coverage than most other plans.

Both a Preferred Provider Organization (PPO) plan and a Health Maintenance Organization (HMO) plan use provider networks. Medical providers in both types of plan networks have contracted to provide their services and facilities to plan participants at reduced costs. Participants of a PPO plan have complete freedom in choosing physicians and medical facilities whenever in need of care.

Health insurance companies generally offer a variety of health insurance plans and options. A PPO is generally a health insurance plan which provides increased benefits when you go to participating panel medical providers. An HMO generally requires that the plan member goes to plan providers and pays little or nothing for the visit. Generally visits to no-plan providers are not permitted except in emergencies.

An HMO is an alternative to Original Medicare and features specific lists of doctors, hospitals, and other providers that you must use to receive benefits. HMOs often provide additional benefits not found in Original Medicare, including coverage for deductibles, steep reductions in co-insurance when you use doctors, a drug benefit plan and wellness or fitness programs. If you select a Medicare Advantage HMO, it replaces your Original Medicare coverage.

With a Medicare Advantage PPO, you can see any doctor you want. However, if you use a doctor who participates in the network, you get a better benefit and lower copayment than if you visit a non-network doctor. Plus, referrals aren’t needed and you don’t have to see a primary care doctor first. In addition to prescription drug benefits, Medicare Advantage PPOs may offer additional benefits such as dental, vision, and nutritional supplements.

Mail in Application:Contact the company offering the drug plan you choose and ask for an application. Once you fill out the form, mail or fax it back to the company. On Medicare's Website: You will also be able to join a drug plan by using Medicare's online enrollment center. By Calling Medicare: You can join a drug plan by calling 1-800-MEDICARE (1-800-633-4227) and talking to a Medicare customer service representative. TTY users should call 1-877-486-2048.

The primary difference is that HMOs limit your non-emergency health care coverage to a limited network of physicians and hospitals. PPO plans insure covered services delivered by any licensed physician or hospital, though a PPO plan will offer improved benefits if you use physicians and hospitals participating in the PPO's preferred network. PPO networks are normally much larger than HMO networks, though HMOs provide higher benefit levels.

Health insurance companies generally offer a variety of health insurance plans and options. A short term plan generally provides medical insurance benefits for a period of time that is otherwise a gap in coverage. It generally terminates at the end of its term. If is generally not guaranteed renewable, and if renewing is an option, a new medical qualification must generally be satisfied.

The level of benefits and the amount of freedom to choose among physicians and hospitals are usually the two main differences. Benefits are also a key difference deductible, co-insurance, co-pays and networks. See below . . . HMO: Health Maintenance Organization provides very rich benefits - preventive care coverage and low out-of-pocket costs. There is typically no coverage for care from doctors or hospitals outside your HMO plan.

Consider what is most important to you in a health plan: cost, availability and location of providers, or freedom to see any doctor. If you like the physician you are currently seeing, check to see if he or she is a provider in the plan that you are considering. If you or a dependent has special medical needs, check that the plan you are considering has adequate medical services and providers for that specialty.

A special arrangement between an insurer and hospitals, physicians and other health care professionals to pay for health care services, resulting in savings for the insured. PPO coverage does not require you to use a PPO doctor. approach to health care utilizing the Primary Care Physician (PCP) concept. HMOs provide preventive care, such as routine physicals, education, and early intervention to decrease occurrence of disease.

These are the types of questions which we need to help you with. You need to talk with one of our account exec's. Please contact Jodi Beidler and she will put you in touch with the right person. You can call Jodi at 319-557-9981 x20 or call 1-877-468-7426 and ask for Jodi Beidler.

Most HMOs require you to select a specific doctor as your primary care physician, or PCP. This doctor is supposed to be your first "port-of-call" for most any medical condition, although exceptions are typically made for emergencies. As such, he or she will end up providing most of your medical care.

HMO is a Health Maintenance Organization, which requires you to select a primary care doctor who helps you manage your health care needs. A PPO is a Preferred Provider Organization, which allows you to select any doctor within the network at the time of service without having to first identify a specific primary care provider. It allows for greater freedom of choice.

On a Health Maintenance Organization (HMO) plan, covered services must be provided or authorized by the member's primary care physician and received from plan (in-network) providers. A referral must be obtained prior to receiving care from specialty providers except for in-network gynecological and obstetrical visits for women and routine eye examinations. Services provided by nonplan (out-of-network) providers are not covered except for emergency care and urgent care.

If you currently have Medicare Part A (Hospital Insurance) and/or Medicare Part B (Medical Insurance), you can join a Medicare prescription drug plan between November 15, 2005, and May 15, 2006. If you join by December 31, 2005, your Medicare prescription drug plan coverage will begin on January 1, 2006. If you join after that, your coverage will be effective the first day of the month after the month you join.

The first time to join is November 15, 2005 - May 15, 2006. In most cases, if you don't join by May 15, 2006, and you don't currently have a drug plan that, on average, covers at least as much as standard Medicare prescription drug coverage, you will have to wait until November 15, 2006 to join. When you do join, your premium cost will go up at least 1% per month for every month that you wait to join.