Different Types 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 your Part A and Part B benefits.

Medicare Advantage Plans include the following:

Health Maintenance Organization (HMO) Plans

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, for out-of-area urgent care or for temporary out-of-area dialysis. You may also need to get a referral from your primary care doctor to see other doctors or specialists.  In exchange for working with a defined Network, these plans OFTEN have lower copays and more extra benefits.

Preferred Provider Organization (PPO) Plans

A Medicare PPO Plan is another type of Medicare Advantage Plan (Part C) offered by a private insurance company.  It has more flexibiliy on using providers BOTH In and Out of Network.  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 Medicare supplement. 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 - DSNP/CSNPs

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. (i.e.  CSNP, DSNP & ISNPs - Chronic Condition, Dual - have both Medicare & Medicaid and Institution SNPs )

To Review Your Best Options, can Call / Text at 346-567-8300, E-mail or Schedule an Appointment at the top right of this web site.

These definitions are directly from www.medicare.gov

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