I wouldn't dream of having an HMO; they make money when they DON'T treat you. If our entire SS payment goes to Medicare plus the PPO supplement (costs 4x as much to pay 20% of the negotiated cost!) plus the drug benefit, I'm happy, although it probably will never come to that. We can go to any doc we want whenever we want (within the usual appointment limits, of course) without having to visit an asshole GP gatekeeper for permission. If we want Ahnold's cardiogenius surgeon to do our valve replacement we can have that. In fact we DID have that!