Health Maintenance Organization (HMO) Plan Can I get my health care from any doctor, other health care provider or hospital? No. You generally must get your care and services from doctors, other health care providers or hospitals in the plan's network. In some HMO plans, you'll be able to go out-of-network for certain services, usually for a higher cost . This is   HMO with a point-of-service (POS) option. Are prescription drugs covered? In most cases, yes. If you want Medicare drug coverage, you must join an HMO Plan that offers prescription drug coverage. Do I need to choose a primary care doctor?   In most cases, Yes. Do I have to get a referral to see a specialist?   In most cases, yes. Certain services, like yearly screening mammograms, don't need a referral. What else do I need to know about this type of plan? If your doctor or other health care provider leaves the plan's network, your plan will tell you. You may choose another ...