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But you will get additional Part A (Hospital Insurance) and Part B (Medical Insurance) coverage from Health First Health Plans, Inc. If you decide to sign up for Health First Rewards Plan (HMO) you still retain Original Medicare. works with Medicare to provide significant coverage beyond Part A and Part B benefits. Services received from an out-of-network provider are not typically covered by the plan. You will need your PCPs okay, called a referral. If you require specialized care or a physician specialist, your primary care physician will make the arrangements and inform you where you can go in the network. Your PCP will serve as your personal doctor to provide all of your basic healthcare services. Health maintenance organizations require that you select a primary care physician (PCP). With a health maintenance organization (HMO) you will be required to receive most of your health care from an in-network provider. Health First Rewards Plan (HMO) is a Local HMO. This means that if you get sick or need a high cost procedure the co-pays are capped once you pay $5,500 out of pocket. The Health First Rewards Plan (HMO) has a monthly premium of $- and has an in-network Maximum Out-of-Pocket limit of $5,500 (MOOP). This plan includes additional Medicare prescription drug (Part-D) coverage. Health First Rewards Plan (HMO) H1099-014 is a 2020 Medicare Advantage Plan or Medicare Part-C plan by Health First Health Plans, Inc.