Social Health Maintenance Organization (SHMO) Law and Legal Definition

A social health maintenance organization (SHMO) is an organization that provides the full range of medicare benefits offered by standard HMO's along with additional services such as, prescription drug benefits, care co-ordination, chronic care benefits covering short term nursing home care, a full range of home and community based services such as homemaker, personal care services, adult day care, respite care, medical transportation, eyeglasses, hearing aids, and dental benefits. SHMO services membership of both disabled and able-bodied elders. They bear responsibility for service costs and are paid on a prepaid capitation basis.

There are currently four SHMO's participating in medicare and each SHMO plan has got different requirements for eligibility and premiums. All plans have co-payments for certain services. The four SHMO plans are located in Portland-Oregon, Long Beach- California; Brooklyn-New York and Las Vegas-Nevada.