Home HMO definition

Home HMO means the participating plan in which a HMO-USA participating plan member is enrolled.

Home HMO means the Participating Plan in which a MEDICARE BLUE USA Participating Plan member is enrolled.

Examples of Home HMO in a sentence

• Eligibility requirements in the OGB PPO medical benefits plan apply to all participants in OGB sponsored health plans including the self funded PPO, HMO, Consumer Driven Health Plan and the Medical Home HMO plan and the OGB life insurance plan.

• Does the Drug List ever change?Yes, and SCAN Connections (HMO D-SNP) and SCAN Connections at Home (HMO D-SNP) must follow Medicare rules when making changes.

• OGB offers fully-insured plans (Vantage Medical Home HMO), Self-Funded plans (BCBS LA HMO, PPO, and CDHP) and Medicare Retiree Specific fully-insured plans.

• However, if a Member chooses to disenroll from the Medical Home HMO Plan and transfer to a standard OGB plan (PPO, HMO or CD-HSA) during annual enrollment, and the transfer of coverage is effective before the 12-month exclusionary period has lapsed, the pre-existing condition limitation will apply under the new plan.

• Effective September 1, 2009, plan members were also offered the Medical Home HMO Plan.

• A formulary is a list of covered drugs selected by SCAN Connections (HMO D-SNP) and SCAN Connections at Home (HMO D-SNP) in consultation with a team of health care providers, which represents the prescription therapies believed to be a necessary part of a quality treatment program.

• The information in the Requirements/Limits column tells you if SCAN Connections (HMO D-SNP) and SCAN Connections at Home (HMO D-SNP) has any special requirements for coverage of your drug.

• Call SCAN Connections (HMO D-SNP) and SCAN Connections at Home (HMO D-SNP) at 1-866-722-6725.

• OGB currently offers a fully insured plan (Vantage Medical Home HMO), Self-funded plans (Administered by BCBS) and Medicare Retiree specific fully insured plans (Administered by OneExchange, Vantage Health Plan, and Peoples Health).Plan participant eligibility includes employees of state agencies, institutions of higher education, school boards and charter schools that elect to participate, and certain political subdivisions.

• Enrollment in SCAN Health Plan depends on contract renewal.❖ You can always check SCAN Connections (HMO D-SNP) and SCAN Connections at Home (HMO D-SNP)’s up-to-date List of Covered Drugs (Formulary) online at www.scanhealthplan.com or by calling 1-866-722-6725.