What Are The Types Of Medicare Advantage Plans?

The United States offers a variety of programs and benefits for people who need assistance with healthcare. One program, in particular, is Medicare, which provides coverage for those over the age of 65 or younger individuals who have been diagnosed with disabilities. This article will outline what types of plans are available through Medicare so that you can determine your options while understanding which type of plan suits your needs and how they are different from one another.

Health Maintenance Organization (HMO) Plans

Health Maintenance Organization (HMO) plans are the most restrictive of all Medicare Advantage plans. They won’t cover any expenses outside of their covered doctors, hospitals, and healthcare providers listed in the plan’s network. With an HMO plan, you must choose a primary care physician who will make referrals to specialists if needed. In addition, you can only go out of network for emergency services or urgent care needs.

Preferred Provider Organization (PPO) Plans

Most people prefer these plans because they offer more flexibility in terms of how you can receive care. You will still need to choose a primary care physician, but then you have the option to see any doctor or specialist that is covered under your plan’s network without needing authorization from your PCP. You can even use out-of-network doctors. However, you’ll end up paying a little extra.

Private Fee-For-Service (PFFS) Plans

These plans are essentially HMO plans that allow you to see any provider as long as they will accept the payment terms of the Medicare Advantage plan. The plan will determine how much it pays hospitals, health care providers, doctors and how much you’ll have to pay when you visit.

Special Needs Plans (SNPs)

These plans are made available to those who need assistance with not only medical care but also other activities of daily living. This type of plan is usually for those who have chronic medical conditions, live in a nursing home, or have Medicaid and Medicare.

HMO Point-Of-Service (HMOPOS) Plans

The HMO Point-Of-Service plan is similar to the HMO plan listed above. You’ll generally want to make appointments with providers, hospitals, and facilities within the network. However, this specific plan allows you to get some services out of the network for a higher coinsurance or copayment cost.

Which Medicare Advantage Plan Is The Best Plan?

Figuring out which Medicare Advantage plan is the best one for you depends on your personal needs, medical history, and what type of support or assistance that you will need throughout the process. For example, if you are on a very limited budget, an HMO might be worth looking into because it can provide excellent coverage at more affordable rates than some other types of plans. 

However, if you are someone who needs the ability to choose doctors outside of your network or have more flexibility when it comes to how much you will be asked to pay for certain services, a PPO plan might be better. Considering all of the above plans, along with their advantages and disadvantages, will help you choose the right Medicare advantage insurance for you. Simply click below to be connected with one of our licensed Medicare Advantage agents!

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