What must Doug know about his coverage when enrolled in an HMO MA plan?

When enrolled in a Health Maintenance Organization (HMO) Medicare Advantage (MA) plan, it is essential for Doug to understand that he must receive covered services from contracted in-network providers. HMO plans require members to select a primary care physician (PCP) who will manage their healthcare needs and provide referrals to specialists when necessary. This structure helps the plan control costs and coordinate care effectively.

The in-network requirement is fundamental to the design of HMO plans, meaning if Doug seeks services from providers outside of this network, he may not receive coverage or may face significantly higher out-of-pocket costs. This aspect of HMO plans emphasizes the importance of staying within the network for receiving healthcare services.

Other choices do not align with the characteristics of HMO plans. For example, the idea that Doug can see any doctor without incurring costs is overly simplistic, as coverage generally depends on the provider being in-network. Similarly, the claim that there are no restrictions on out-of-network providers does not apply, given the HMO's focus on in-network care. Finally, while HMO plans may provide benefits that are comparable to Original Medicare, they are not guaranteed to be the same, as each plan may offer different coverage options and additional benefits.