- term
- SOCIAL HEALTH MAINTENANCE ORGANIZATION (SHMO)
- normalized_term
- social-health-maintenance-organization
- category
- plans
- alias
- SHMO
- alias
- social HMO
- alias
- enhanced Medicare HMO
- definition
- A special type of health plan that provides the full range of Medicare benefits offered by standard Medicare HMOs, plus other services that include the following: prescription drug and chronic care benefits, respite care, and short-term nursing home care; homemaker, personal care services, and medical transportation; eyeglasses, hearing aids, and dental benefits.
- related_term
- health-maintenance-organizations-hmo
- related_term
- managed-care-plan
- related_term
- programs-of-all-inclusive-care-for-the-elderly-pace
- related_term
- health-plan
- source_url
- https://www.cms.gov/glossary?searchterm=&items_per_page=30&viewmode=list&page=29
- publisher
- MedicarePlans.com
- license
- CC-BY-4.0
Social Health Maintenance Organization (SHMO) refers to a specialized Medicare health plan that combines standard Medicare HMO coverage with expanded healthcare and supportive care services.
🧠 Full Definition
Social Health Maintenance Organization (SHMO) is a specialized type of Medicare health plan that provides the full range of benefits available through traditional Medicare HMOs while also offering additional healthcare and supportive services.
These expanded benefits may include prescription drug coverage, chronic care services, respite care, short-term nursing home care, homemaker assistance, personal care services, medical transportation, eyeglasses, hearing aids, and dental services.
SHMOs were designed to provide more comprehensive healthcare and supportive care coordination for elderly beneficiaries with ongoing healthcare and long-term support needs.
📌 Key Characteristics
- Operates as an enhanced Medicare HMO plan
- Provides standard Medicare HMO healthcare benefits
- Includes expanded supportive and chronic care services
- May cover prescription drugs, transportation, and personal care services
- Focuses on coordinated healthcare and long-term support needs
💡 Why It Matters
Understanding Social Health Maintenance Organization (SHMO) plans helps beneficiaries evaluate healthcare coverage options that combine medical care with supportive community-based services.
These plans can affect:
- access to expanded healthcare benefits
- chronic care coordination
- long-term supportive care services
- out-of-pocket healthcare costs
- community-based healthcare support
🌐 MedicarePlans.com Perspective
SHMO plans were designed to bridge healthcare and supportive care services for older adults with more complex healthcare needs. These plans helped pioneer integrated care approaches that combined traditional Medicare coverage with additional long-term support services.
🗣️ Example Use
“The beneficiary enrolled in a Social Health Maintenance Organization (SHMO) plan that included prescription drug coverage, transportation assistance, and chronic care services.”
🔗 Related Terms
- Health Maintenance Organizations HMO
- Managed Care Plan
- Programs Of All-Inclusive Care For The Elderly (PACE)
- Health Plan
📚 Source Definition
Original definition sourced from the Centers for Medicare & Medicaid Services (CMS).
SOCIAL HEALTH MAINTENANCE ORGANIZATION (SHMO): A special type of health plan that provides the full range of Medicare benefits offered by standard Medicare HMOs, plus other services that include the following: prescription drug and chronic care benefits, respite care, and short-term nursing home care; homemaker, personal care services, and medical transportation; eyeglasses, hearing aids, and dental benefits.
Page content independently curated and maintained by David W. Bynon, Healthcare AI Governance Architect & Medicare Systems Steward, using a standardized, data-driven methodology designed for accurate, non-commercial Medicare plan interpretation and resolution.