Some HMOs charge a premium in addition to your Medicare Part B premium . HMO premiums and benefits change annually. However, beneficiaries can choose to go to providers who are not in the network, and the plan will pay a percentage of the cost. The beneficiary is responsible for the rest. There is no insurance company involved.
Plans are private indemnity-type insurance plans.
The insurance plan, rather than Medicare, determines how much to reimburse providers. The beneficiary may also be responsible for additional premiums.