Medicare Advantage Plans

There are the different types of Medicare Advantage Plans:

• Health Maintenance Organization (HMO) plans—In most HMOs, you can

only go to doctors, other health care providers, or hospitals in the plan’s network,

except in an urgent or emergency situation. You may also need to get a referral

from your primary care doctor for tests or to see other doctors or specialists.

• Preferred Provider Organization (PPO) plans—In a PPO, you pay less if you

use doctors, hospitals, and other health care providers that belong to the plan’s

network. You usually pay more if you use doctors, hospitals, and providers outside

of the network.

• Private Fee-for-Service (PFFS) plans—PFFS plans are similar to Original

Medicare in that you can generally go to any doctor, other health care provider,

or hospital as long as they accept the plan’s payment terms. 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.

• Special Needs Plans (SNPs)—SNPs provide focused and specialized health care

for specific groups of people, like those who have both Medicare and Medicaid,

live in a nursing home, or have certain chronic medical conditions.

• HMO Point-of-Service (HMOPOS) plans—These are HMO plans that may allow

you to get some services out-of-network for a higher copayment or coinsurance.

•Medical Savings Account (MSA) plans—These plans combine a high-deductible

health plan with a bank account. Medicare deposits money into the account

(usually less than the deductible). You can use the money to pay for your health

care services during the year. MSA plans don’t offer Medicare drug coverage. If

you want drug coverage, you have to join a Medicare Prescription Drug Plan.