Medicare Advantage Plans, also known as Medicare Part C, are designed to provide all the same benefits of original Medicare Parts A & B, and usually Part D. These plans are sold by private insurance companies who have contracted with Medicare to provide you with these benefits, and many times some additional benefits not offered by Medicare. Medicare Advantage plans include HMO’s, PPO’s, Private-Fee-For-Service plans, Special Needs Plans and Medicare Medical Savings Account Plans.
HMO Plans – In most HMO (Health Maintenance Organization) plans you may only go to doctors, other health care providers, and hospitals on the plans list unless it’s an emergency. You may also need to get a referral from your primary care doctor to go see a specialist. These plans are generally based on where you live, so if you’re outside of your home area, you may have to pay full cost for health care (unless it’s an emergency). Prescription drugs are usually covered in an HMO type plan.
PPO Plans – A PPO (Preferred Provider Organization) Plan you will pay less if you use doctors, hospitals and health care providers who are in-network. If you go to out-of-network providers you’ll pay more. These offer more fexibility than an HMO Plan because you don’t have to choose a primary care doctor, and you can go directly to any doctor or specialist that is in the network. Most plans will also cover prescription drugs.
Private Fee For Service (PFFS) Plans – These plans allow you to go to any doctor, hospital or healthcare provider who accepts your plan. There is not always a network in place (although sometimes there is a network), and healthcare providers could stop accepting your plan at any time. These plans usually allow you to get healthcare when out of your home state area, you just need to check with the doctor first to make sure they accept your plan. You do not need a referral to see a specialist in a PFFS plan. Most PFFS plans cover prescription drugs.
Medicare Special Needs Plans (SNP’s) limit their membership to individual with specific diseases and tailor benefits to the needs of those members. SNP’s will usually have in-network specialists that their members would need to see, and cover drugs that they would need to use. In most cases you would need to choose a primary care doctor and get referrals to see specialists. Certain services like annual mammograms and pelvic exams would not need a referral to see a specialist. Here are some examples of SNP groups: people confined to nursing homes, people with kidney failure, people with Medicare and Medicaid, people with AIDS/HIV, chronic heart failure, or dimensia, etc. You can join an SNP at any time.
Medicare Medical Savings Account (MSA) Plans are offered through private insurance companies and are similar to HSA’s outside of Medicare. These plans combine a high deductible Medicare Advantage Plan with a Medical Savings Account. The Medicare MSA Plan deposits money into your Medical Savings Account and then you can use it to pay for your healthcare costs before you meet your deductible. MSA plans DO NOT cover Part D presciption drug costs. You would have to purchase a Part D plan separately.
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Fill out the form below to start your application for a Medicare Advantage Plan. One of our licensed agents will call you shortly to fill in the blanks and educate you on the best available plans in your area. We work with all the major providers of Medicare Advantage plans across the country. We can help you find the plan that will best meet your needs.