Medicare Advantage is also known as Medicare Part C plans. It is a type of healthcare insurance that provide coverage in the United States through private insurance companies approved by Medicare. For a beneficiary of Medicare Advantage he or she must sign up for both Part A and B of the Medicare. It thus provides you an alternative way to receive your original Medicare. Each Medicare Advantage plan offers you a specific benefit therefore, it is important for you to compare the plan’s benefits and identify which one is right for you. There are several types of Medicare Advantage plans they include the following:
Health Maintenance Organization (HMO)
This is a type of health-care whereby it requires you to choose a primary doctor. In most cases, if you want to see a specialist you must get a referral. You may have to pay the full cost of care if you end up not following the plan’s rules. For services obtained outside the plans of Medicare, you are not typically covered except under certain circumstances.
Private Fee-For-Service (PFFS)
Generally, you will not need to choose a primary doctor and referrals are not required for treatment by specialists with a PFFS plan. PFFS plans were the fastest growing segment at one time in the Medicare Advantage market. These plans were not tied to a specific doctor or hospital network and thus were very popular. If you consider choosing this kind of plan, make sure you are clear with what the requirements are and also the particular plan about which providers you can go to.
Preferred Provider Organization (PPO)
With this kind of Medicare Advantage, you can go to any doctor generally. It is also advantageous since you will pay less amount of money if you use hospitals and doctors that belong to the plan’s network. You typically don’t require a referral for care by a specialist when you consider PPO health plan right for you. However, you may be required to pay a higher cost if you use out-of-network specialists or health care providers.
Special Needs Plans (SNPs)
This kind of Medicare Advantage is available to those who have specialized needs or those with specific situations. For example, those living in an institution such as nursing homes like the elderly. Hence, those who have severe chronic condition such as heart failure are eligible for an SNP. These plans benefit those with specific needs.