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Frequently Asked Questions

There are a number of frequently asked questions and answers that may help you better understand Accountable Care Organizations. Click here for a print-friendly version of the FAQs.

If my doctor’s in an ACO, can I still see whatever doctor I want?

Absolutely—if your doctor participates in an ACO, you can see any healthcare provider who accepts Medicare. Nobody—not your doctor, not your hospital—can tell you who you have to see.

Is an ACO a Health Maintenance Organization (HMO), managed care or an insurance company?

No. An ACO is a group of doctors, hospitals, and other health care providers who work together to provide you with better, more coordinated care. Doctors and hospitals in an ACO communicate with you and with each other to make sure that you get the care you need when you are sick, and the support you need to stay healthy and well.

An ACO isn’t an HMO, managed care or insurance company. Unlike HMOs, managed care, or some insurance plans, an ACO can’t tell you which health care providers to see and can’t change your Medicare benefits. If your doctor participates in a Medicare ACO, you always have the right to choose any doctor or hospital who accepts Medicare at any time.

What should I expect if my doctor is in an ACO?

Over time, if you see a doctor participating in an ACO, you may notice that:

  • You don’t have to fill out as many medical forms that ask for the same information.
  • The health care providers that you see all know what is going on with your health because they communicate with each other.
  • You don’t have to have the same medical tests done over and over because your results are shared among your health care team.
  • The providers participating in the ACO will become partners with you in making care decisions.

Here are things that won’t change because your doctor is part of an ACO:

  • What you pay, your Medicare benefits, or the cost of your coverage should not increase.
  • Your right to choose any hospital or doctor that accepts Medicare, at any time, will not change even if that hospital or doctor is not part of an ACO.

What rights do I have if my doctor is in an ACO?

You will continue to receive the same rights enjoyed by all people with Medicare. To help you to get the best-coordinated care, Medicare will share information about your medical information with your doctor’s ACO, including medical conditions, prescriptions, and visits to the doctor. This is important to help the ACO keep up with your medical needs and track how well the ACO is doing to keep you healthy and helping you get the right care.

Your privacy is very important to us, so you may choose to have your name and other personal information removed from the information that Medicare shares with your doctor.

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