Medicare Advantage Plans are a type of Medicare health plan offered by a private company that contracts with Medicare to provide all your Part A and Part B benefits. Most Medicare Advantage Plans also offer prescription drug coverage. If youíre enrolled in a Medicare Advantage Plan, most Medicare services are covered through the plan. Your Medicare services arenít paid for by Original Medicare. Below are the most common types of Medicare Advantage Plans.
What is Medicare Advantage?
Also known as Medicare Part C, Medicare Advantage plans are designed to provide the same coverage as Medicare Part A and Part B, while offering additional benefits not found in Original Medicare.
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Types of Medicare Advantage Plans
In HMO Plans, you generally must get your care and services from providers in the plan's network, except:
In some plans, you may be able to go out-of-network for certain services. But, it usually costs less if you get your care from a network provider. This is called an HMO with a point-of-service (POS) option.
A Medicare PPO Plan is a type of Medicare Advantage Plan (Part C) offered by a private insurance company. PPO Plans have network doctors, other health care providers, and hospitals. 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.
A Medicare PFFS Plan is a type of Medicare Advantage Plan (Part C) offered by a private insurance company. PFFS plans arenít 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 SNPs are a type of Medicare Advantage Plan (like an HMO or PPO). Medicare SNPs limit membership to people with specific diseases or characteristics. Medicare SNPs tailor their benefits, provider choices, and drug formularies to best meet the specific needs of the groups they serve.
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