Medicare HMOs may not be the ultimate answer to geriatric care, but they continue to grow in number and are becoming increasingly popular among the elderly. Independent practice association (IPA) groups are the fastest growing type. Problems concerning quality of care and cost, exemplified in the extreme by the recent case of the International Medical Centers HMO in Florida, have illustrated the need for greater regulation of Medicare HMOs by the Health Care Financing Administration. The author outlines the advantages and disadvantages of a prepaid health plan for elderly patients, as well as for the physicians who are members. Three methods of creative geriatric programming are suggested; these would promote continuity of care and decrease hospitalization rates, yet pose no risk to patients.