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Medicare Advantage

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What is Medicare Advantage?

A Medicare Advantage a type of Medicare health plan obtainable by a private company that has contract with Medicare to provide you with all your Medicare benefits.  The majority Medicare Advantage Plans offer prescription drug coverage. Medicare Advantage Plans are made up of:

Health Maintenance Organizations (HMO):

In the majority HMO Plans, you can only go to doctors, other health care providers, or hospitals on the plan’s list except for in an emergency. You may also need to get a referral from your primary care doctor. In HMO Plans, you cannot get your health care from any doctor, other health care provider, or hospital. In general must get your care and services from doctors, other health care providers, or hospitals in the plan’s network.

Preferred Provider Organizations (PPO):

In a PPO Plan, you pay less if you use doctors, hospitals, and other health care providers that belong to the plan’s network. You will have to pay more if you use doctors, hospitals, and providers outside of the network. A PPO Plan is not the same as Original Medicare or a Medicare Supplement Insurance policy. PPO Plans typically offer extra benefits than Original Medicare, but you possibly will have to pay additional for these benefits.

Private Fee-for-Service Plans (PFFS):

In PFFS plans are not the same as Original Medicare or Medicare Supplement. The plan determines how much it will pay doctors, or other health care providers, and hospitals, and how much you have to pay when you receive care.  You may go to any Medicare-approved doctor, health care provider, or hospital that accepts the plan’s payment terms and agrees to treat you.  But not all providers will.

Special Needs Plans (SNP):

In SNP plan, Medicare limits membership to people with specific diseases or characteristics. Medicare SNPs adapts their benefits, provider choices, and drug formularies to best meet the specific requirements of the groups they serve. Every SNP must provide Medicare prescription drug coverage.

Medicare Medical Savings Account (MSA):

Medicare MSA Plans combine a high-deductible insurance plan with a medical savings account that can be use to pay for your health care costs. The plan only begins to cover medical expenses once you meet a high yearly deductible, which can vary from plan to plan.

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National Senior Services is not connected with or endorsed by the US government or the federal Medicare program; Medicare has neither reviewed nor endorsed this information. We are a licensed and approved Medicare Service Provider.

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