Which of the following statements is correct about HMO MA Plans?

The correct statement regarding HMO MA (Health Maintenance Organization Medicare Advantage) Plans is that members must receive covered services from contracted network providers. This is a fundamental aspect of HMO plans, as they are designed to provide coordinated care and often emphasize the importance of using a specific network of providers to ensure that care is managed effectively and costs are controlled.

HMO plans typically require members to select a primary care physician (PCP) who will oversee their care and provide referrals to specialists within the network. This structured approach not only helps to maintain the continuity of care but also allows the HMO to negotiate better rates with providers, which can result in lower overall costs for members.

Using contracted network providers is essential for accessing the full benefits of the plan, as out-of-network services are typically not covered except in emergencies. This model is built on the premise that members will engage with a defined network of doctors, clinics, and hospitals to promote preventive care and early intervention, ultimately leading to better health outcomes and more efficient use of healthcare resources.