Premium Choice Explains the Different Types of Medicare Advantage Plans

Medicare Advantage Plans are those designed to help seniors and older citizens get the most out of their existing Medicare Part A and Part B Plans. They're referred to by a number of different names, including but not limited to Medicare Part C and even simply by MA.

Of course, the team at Premium Choice understands that healthcare is a complicated topic and Medicare is certainly no exception. With that in mind, here is an overview of everything you need to know about the various types of Medicare Advantage Plans that are available.

The Types of Medicare Advantage Plans: Breaking Things Down

The first type of Medicare Advantage Plan that people can choose to purchase is called a Health Maintenance Organization Plan. Otherwise, known as an HMO, this is a plan that requires you to get all of your care through a provider in your network with the exception of situations like emergency care or urgent care.

In the majority of situations, an HMO plan will cover prescription drugs and if it doesn't, Medicare Part D is also available. If the doctor you've been seeing ends up leaving the network, you will be notified and you'll be able to choose someone else who you feel comfortable with.

Another type of Medicare Advantage Plan is called the PPO plan, or Preferred Provider Organization. These plans are offered by private companies and, typically, allow you to see any doctor you'd like. Prescription drugs are once again typically covered and you won't need to first choose a primary care doctor in order to participate in one of these plans.

Also available are Private Fee-for-Service plans, otherwise known as PFFS plans. With these, you're once again dealing with a private insurance company. What makes it different from traditional Medicare or even Medigap coverage is the fact that the plan itself determines how much you will pay versus how much they will pay for the healthcare services you receive.

Under this plan, prescription drugs may be covered (again, it will ultimately come down to the plan you select) and you won't need to get any type of a referral before you're allowed to see a specialist.

Last but not least, there are Special Needs plans, which are also commonly abbreviated as SNP. Here, membership in a plan is limited to only those who have specific diseases or conditions. This is because each plan will customize the benefits being offered to meet the needs of the specific patient based on the characteristics that they display.

This includes but is not limited to the choice of provider you go to and even aspects of prescription medications.

With an SNP, you will likely have to choose a primary care doctor to participate if you don't already have one. You will also likely need to get a referral before seeing a specialist. The only exceptions are for yearly mammograms, pap tests, and pelvic exams (the latter two happen every other year).