Medicare Advantage Plans Explained

You may already know that Medicare Part A pays for hospital and facility costs, while Medicare Part B pays for services from doctors and other health care providers.

 

But do you know about Medicare Part C? Also known as Medicare Advantage, it combines coverage for hospital care, doctor visits, and other medical services into one convenient plan. What’s even better? Most Medicare Advantage Plans include drug coverage known as, you guessed it, Medicare Part D!

 

If you think a Medicare Advantage Plan is right for you, here are four plans you can choose from:

  • Health Maintenance Organization (HMO) Plan: In an HMO Plan, you receive care and services from providers in the plan's network except in the case of emergency care, out-of-area urgent care, or out-of-area dialysis.

  • Preferred Provider Organization (PPO) Plan: A PPO Plan has network doctors, other health care providers, and hospitals. You pay less if you use doctors, hospitals, and other providers that belong to the plan's network. You pay more if you use doctors, hospitals, and providers outside of the network.

  • Private Fee-for-Service (PFFS) Plan: A PFFS plan pre-determines how much it will pay doctors, other health care providers, and hospitals and how much you will pay when you receive care.

  • Special Needs Plan (SNP): SNP plans limit their membership to people with specific diseases or conditions. Medicare SNPs tailor their benefits, provider choices, and drug plans to best meet the needs of the members they serve.

By way of reminder, Medicare isn’t allowed to call and try to enroll you in a plan--that is unless you specifically ask to be called. Additionally, never give out your financial information to include credit card or bank account numbers over the phone.

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Medicare Part B Explained

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Medicare For Individuals Working Past 65