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Medicare Advantage Plans
(Medicare Part C)

Medicare Advantage Plans are run by private companies and combine Medicare Part A and B benefits all in one plan. Medicare Advantage Plans include Preferred provider Organizations (PPO), Health Maintenance Organizations (HMO), Private Fee-for-Service Plans (PFFS), Medicare Savings Account Plans (MSA) and Special Needs Plans (SNP).

Medicare PPO Plans

Medicare PPO Plan may allow you to pay less if you are using plan network providers for your health care. However, you enjoy the freedom to see providers that are out of the network without a referral and you may pay a higher co-payment amount depending upon the health care provider.

Medicare HMO Plans

Medicare HMO Plans offer network providers for health care coverage. Although this plan covers all Original Medicare benefits and services, prescription drug coverage may not always be included. These plans typically require a referral to see a doctor other than your primary care physician.

Medicare PFFS Plans

In a Medicare PFFS Plan, you can contact any health care provider who is approved by Medicare and accepts the plan’s terms and conditions. Prescription Drug Coverage may or may not be available in Medicare PFFS Plans. In this type of plan, it is permissible for you to seek a stand-alone Medicare Prescription Drug Plan (PDP) to obtain coverage.

Medicare MSA Plans

Medicare MSA Plan is a type of plan that combines a high deductible plan with a bank account. Medicare deposits money into the account to be used for health care services. If you exceed the monies in the account due to health care costs, then you are responsible for your Medicare-covered health care costs, until you meet the deductible no Medicare Prescription drug coverage is provided in a Medicare MSA Plan. However, you can seek a Medicare Prescription Drug Plan (PDP) for your drug coverage.

Medicare SNP Plans

Medicare SNPs are a type of Medicare Advantage Plan (like an HMO). Medicare SNPs limit membership to people with specific diseases or characteristics, and tailor their benefits, provider choices, and drug formularies to best meet the specific needs of the groups they serve. Medicare SNPs networks typically have specialists in the diseases or conditions that affect their members.