Different Parts Of Medicare Advantage Plans


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    Different Parts of Medicare Advantage Plans

    Medicare Advantage is a type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all of your Part A, Part B and Part D benefits. An advantage plan REPLACES original medicare but BY LAW must provide at least the same benefits as Original Medicare. The benefit of choosing an Advantage Plan is that it provides MORE THAN Original Medicare and can be at ZERO COST.

    Please note that Medicare Supplement plans are NOT Medicare plans as they do NOT replace Medicare. They work alongside Medicare.  In most cases, you’ll also need a Prescription Drug coverage plan (PART D) which comes at an additional monthly cost. 

    Medicare Advantage Plan types are as follows.  Each plan has different features and benefits::

    Health Maintenance Organization (HMO) Plan
    In most HMO Plans, you can only go to doctors, other health care providers, or hospitals on the plan’s list except in an emergency. You may also need to get a referral from your primary care doctor to see other doctors or specialists. Find and compare HMO Plans in your area.

    Preferred Provider Organization (PPO) Plans
    A Medicare PPO Plan is a type of Medicare Advantage Plan (Part C) offered by a private insurance company. In a PPO Plan, you pay less if you use doctors, hospitals, and other health care providers that belong to the plan’s network. You pay more if you use doctors, hospitals, and providers outside of the network.

    Private Fee-for-Service (PFFS) Plans
    A Medicare PFFS Plan is a type of Medicare Advantage Plan (Part C) offered by a private insurance company. PFFS plans aren’t the same as Original Medicare or Medigap. The plan determines how much it will pay doctors, other health care providers, and hospitals, and how much you must pay when you get care.

    Medicare Special Needs (SNP) Plans
    Medicare SNPs are a type of Medicare Advantage Plan (like an HMO or PPO). Medicare SNPs limit membership to people with specific diseases or characteristics, and tailor their benefits, provider choices, and drug formularies to best meet the specific needs of the groups they serve. Find out who can join a Medicare SNP.

    Contact me to help you locate carriers and plans that offer each of the above plans with options that are suited to your specific needs.

    These definitions are from www.medicare.gov

    By contacting the phone number on this website you will be directed to a licensed agent.


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