Medicare Advantage Plans: What are the Options?

When a private company covers your Medicare Part A and B coverage it is called a Medicare Advantage Plan. There are several options for this coverage and they are listed below.

Health Maintenance Organization (HMO) Plans: Except in an emergency situation you must go to the doctors or health care providers listed when you use an HMO. Your primary care doctor could give you a referral also.

Preferred Provider Organization (PPO) Plans: In contrast to the HMO the PPO suggests which doctors, hospitals and other healthcare providers to use, but only gives you a discount instead of disallowing them. Basically this makes it more expensive to go outside of their network.

Private Fee-for-Service (PFFS) Plans- As long as the doctor, hospital or healthcare provider agrees to see you it is covered for you when you have this plan. It is dependent on the plan to find out how much the healthcare provider, doctor or hospital gets paid and how much you have to pay.

Special Needs Plans (SNP)-If you live in a nursing home, have a chronic medical condition or you are on both Medicaid and Medicare you may use one of these plans for people with specialized health care coverage.

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