HMO Guide for Seniors - Office of the Patient Advocate - State of ...
HMO Guide for Seniors - Office of the Patient Advocate - State of ...
HMO Guide for Seniors - Office of the Patient Advocate - State of ...
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49<br />
Questions & Answers<br />
What if I have an emergency<br />
and <strong>the</strong> nearest hospital is<br />
not in my Medicare <strong>HMO</strong>’s<br />
network?<br />
Your Medicare <strong>HMO</strong> must<br />
cover emergency care at any<br />
hospital. But you should<br />
call your <strong>HMO</strong> as soon as<br />
you can. You may be moved<br />
to a hospital in your <strong>HMO</strong>’s<br />
network as soon as your<br />
condition is stable.<br />
Are ambulance services<br />
covered?<br />
Yes. Your Medicare <strong>HMO</strong><br />
must cover ambulance<br />
services to take you to a<br />
hospital in an emergency.<br />
I got a bill <strong>for</strong> ambulance<br />
services. Do I have to pay it?<br />
Check your bill. If it is <strong>for</strong><br />
a co-pay, you should pay it.<br />
If it is a bill <strong>for</strong> <strong>the</strong> full<br />
amount <strong>of</strong> <strong>the</strong> services,<br />
submit it to your Medicare<br />
<strong>HMO</strong>’s claims department.<br />
things you can do<br />
Be Prepared<br />
Know your Medicare <strong>HMO</strong>’s rules <strong>for</strong> getting<br />
emergency and urgent care.<br />
Ask about <strong>the</strong> co-pays <strong>for</strong> emergency room visits<br />
and ambulance services.<br />
Know <strong>the</strong> hospitals and urgent care centers in<br />
your <strong>HMO</strong>’s network.<br />
Always keep your Medicare <strong>HMO</strong> membership<br />
card with you.<br />
Use an ambulance only <strong>for</strong> an emergency. If you<br />
need a ride home from <strong>the</strong> hospital, use a taxi or<br />
paratransit van.<br />
If You’re Not Sure It’s an Emergency<br />
Sometimes it is hard to know if you need emergency<br />
care. If you have time, call your doctor or <strong>HMO</strong>.<br />
Many <strong>HMO</strong>s have 24-hour nurse advice helplines.<br />
When You Travel<br />
All Medicare <strong>HMO</strong>s pay <strong>for</strong> emergency and urgent<br />
care nationwide. Ask your <strong>HMO</strong> if it covers any care<br />
outside <strong>the</strong> U.S.<br />
where to find help<br />
Police, Fire, or Ambulance<br />
Emergency services<br />
9-1-1