MA HMO plans typically have OON coverage for medical emergencies but no coverage if your care is not an emergency.
I got a call from a guy yesterday that is currently covered under a KP HMO. He is 77 yrs old and has been on the MA plan since turning 65. He needs back surgery but doesn't "like" the KP surgeons.
On his own he found a doctors group that is affiliated with Emory Hospital but is not in the KP network. The doc participates in Medicare but not KP.
Is it possible for him to use that doc and hospital for his surgery and be covered under Medicare? If so he would be responsible
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I got a call from a guy yesterday that is currently covered under a KP HMO. He is 77 yrs old and has been on the MA plan since turning 65. He needs back surgery but doesn't "like" the KP surgeons.
On his own he found a doctors group that is affiliated with Emory Hospital but is not in the KP network. The doc participates in Medicare but not KP.
Is it possible for him to use that doc and hospital for his surgery and be covered under Medicare? If so he would be responsible
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