Medicare Advantage Plans
Medicare Advantage plans are offered by private insurance companies that are contracted through Medicare as alternatives for Original Medicare. These plans include all of the benefits of Medicare Part A (hospital) and Part B (medical). And they may also include benefits that may are available through Medicare Parts A and B, such as prescription drug coverage, dental or vision coverage. --And all for an affordable (sometimes $0) monthly plan premium. There are different types of Medicare Advantage plans: Preferred Provider Organizations (PPOs), Health Maintenance Organizations (HMOs), Private Fee-for-Service Plans (PFFS), Special Needs Plans (SNP), Medicare Medical Savings Account Plans (MSA) and HMO Point of Service Plans (HMOPOS).
One important difference between these plan types is where you can receive covered treatment. A Preferred Provider Organization has what is commonly referred to as a network of coverage. This means that there is a network of preferred facilities and physicians that are pre-approved for coverage with your plan. As long as you stay within this network, you will not incur any unexpected costs from covered procedures and examinations. The Medicare Advantage Plan you choose can have a big impact on your out-of-pocket costs, and may have different rules for how you can receive certain services (like Specialist doctor visits, for example).
Health Maintenance Organizations have a network of pre-approved service providers that will be covered within your plan. However, a major difference with this type of plan is that in most cases you must select a primary care physician. This primary care physician acts will act your personal doctor, and also as your health care coordinator. If you ever needed to see a Specialty doctor who is not in your HMO plan network, your primary care physician could offer you a referral if they deem it necessary. You may need to obtain a referral from your primary care physician in order for the service to be covered.
To get more information on your different Medicare Advantage Plan options, you can schedule a call from one of our licensed agents by clicking HERE. You can also obtain more general information at Medicare.gov.