top of page

Medicare Advantage 

Medicare Advantage plans come in several types, each with its own set of rules and benefits. Here are the main types:

​

  • Health Maintenance Organization (HMO): This type of plan requires you to choose a primary care doctor who coordinates your care. You must use doctors and hospitals within the plan's network to receive coverage, except in emergencies. Referrals are usually needed to see specialists.

  • Preferred Provider Organization (PPO): PPO plans offer more flexibility in choosing healthcare providers. You can see any doctor or specialist without a referral, but you'll pay less if you use providers in the plan's network. You can also use out-of-network providers at a higher cost.

  • Point of Service (POS): POS plans combine features of HMO and PPO plans. You choose a primary care doctor and need referrals to see specialists, but you can also use out-of-network providers at a higher cost.

  • Private Fee-for-Service (PFFS): PFFS plans allow you to see any Medicare-approved doctor or hospital that accepts the plan's payment terms. The plan decides how much it will pay providers and how much you will pay. You may have more flexibility in choosing providers, but costs can vary.

​

Each type of plan has its own advantages and disadvantages, so it's important to consider your healthcare needs and preferences when choosing a Medicare Advantage plan.

bottom of page