Medicare Advantage Plans

Medicare Advantage Plans (like an HMO or PPO) are health plans run by Medicare-approved private insurance companies.

Medicare Advantage Plans (also called “Part C”) include Part A, Part B, and usually other coverage like Medicare prescription drug coverage (Part D), sometimes for an extra cost.

Medicare Advantage plans offer all of the benefits covered under Original Medicare and more. Many plans also include Medicare Part D prescription drug coverage. Depending on residency, there may be several Medicare Advantage plans to choose from including HMO, POS, PPO and PFFS plans.

HMO Plans are coordinated care Medicare Advantage plans also known as Health Maintenance Organization (HMO) plans. HMO plans have a network of local doctors and hospitals.

HMO-POS Plans are Health Maintenance Organization plans that offer a Point-of-Service (POS) option. POS plans give members the flexibility to go out of the network to receive some health care services.

PPO Plans are Preferred Provider Organization (PPO) plans. PPO plans provide access to a network of local doctors and hospitals but also allow the flexibility to use physicians or hospitals outside the network. For most of these plans a referral is not needed for specialty care.

C-SNP or D-SNP Medicare Advantage Special Needs Plans provide health care coverage for people with a chronic disease or illness, who live in an institution or who qualify for both Medicare and Medicaid (also referred to as “dual eligible”).

Medicare Supplement

Medi-Gap Medicare Supplement plans typically provide more freedom to choose doctors and hospitals, and see specialists without referrals. Medicare Supplement plans also offer National coverage.

Prescription Drug Plans

Prescription Drug Plans (PDP) provide a way to add drug coverage to Original Medicare or Medicare Supplement coverage.