Medicare Advantage

SHARE

Medicare Advantage, also known as Medicare Part C, is provided by private insurance companies approved by Medicare as a substitute for Original Medicare (consisting of Parts A and B).

These plans are required to encompass all the services offered by Original Medicare, which includes hospital insurance (Part A) and medical insurance (Part B). However, they are permitted to extend additional benefits beyond the scope of Original Medicare, such as coverage for prescription drugs, vision, dental, and hearing services.

Different Plan Types

Medicare Advantage plans come in various types:

Health Maintenance Organization (HMO) Plans

HMO Plans

HMOs are cheaper than other Medicare Advantage plans. They require plan members to use their in-network providers and choose a primary care doctor.

Learn More

Preferred Provider Organization (PPO) Plans

PPO Plans

PPOs offer more flexibility. You can use out-of-network providers but at a higher cost. Plan members don’t have to choose a primary care doctor or get referrals to see specialists.

Learn More

Special Needs Plan (SNP)

SNP

SNPs are for those who are dually eligible for Medicare and Medicaid (D-SNP), have chronic and disabling conditions (C-SNP), or are living in an institution (I-SNP).

Learn More

Private Fee-For-Service (PFFS) Plans

PFFS Plans

PFFS plans negotiate what you will pay and what they will pay for every visit, giving you the benefit of knowing what your costs will be beforehand. You can see any doctor who accepts the terms and conditions of your PFFS plan.

Learn More

Medicare Medical Savings Account (MSA)

MSA

MSA plans use a savings account and high deductible plan to pay for medical costs.

Learn More

Different Plan Types

There are several types of Medicare Advantage plans:

Health Maintenance Organization (HMO) Plans

HMO Plans

Compared to other Medicare Advantage plans, HMOs are less expensive. They mandate that plan participants select a primary care physician and utilize their in-network providers.

Learn more

Preferred Provider Organization (PPO) Plans

PPO Plans

PPOs provide greater adaptability. Out-of-network providers are available, albeit they will cost you more. Plan members are not required to obtain referrals to see specialists or select a primary care physician.

Learn more

Special Needs Plan (SNP)

SNPs are for people who live in an institution (I-SNP), have chronic and incapacitating conditions (C-SNP), or are dual eligible for Medicare and Medicaid (D-SNP).

Learn More

Private-Fee-For-Service (PFFS) Plans

PFFS Plans

PFFS plans provide you with the advantage of knowing your costs in advance by negotiating what you will pay and what they will pay for each visit. Any physician who agrees to the terms and conditions of your PFFS plan may be seen by you.

Learn More

Medicare Medical Savings Account (MSA)

Medical expenses are covered by MSA plans through a high deductible plan and savings account.

Learn More

Cost-Effectiveness

Generally, Medicare Advantage plans combine multiple types of coverage at a reduced cost compared to purchasing Original Medicare, Medigap, and prescription drug coverage separately. Costs, however, may differ depending on the precise plan, insurance provider, and area.

Enrollment and Eligibility

You must reside in the plan’s service area and be enrolled in Original Medicare in order to be eligible. Certain enrollment periods, such as the Annual Enrollment Period that happens annually or the Initial Enrollment Period when you initially become eligible for Medicare, allow you to enroll.

Ready to Learn More? Let’s Talk!

Our goal at Insurance Corner Medicare Group is to offer you the finest possible coverage.

Koran Smith

Owner & Licensed Agent

By clicking “Next”, you agree to our Terms of Service and Privacy Policy. You also elect to receive updates, newsletters, and offers from Delta Medicare Benefits Group.