MEDICARE ADVANTAGE

The “All in one” alternative to Original Medicare

The three type of Medicare Advantage Plans

Medicare Advantage Plans, also know as Part C, can help you from unexpected costs. The three type of advantage plans are HMO, PPO, AND PFFS.

WHAT ARE MEDICARE ADVANTAGE (MA) HEALTH PLANS?

Medicare Advantage Plans include Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage as well as other benefits.

Most plans offer health and drug coverage, as well as extra benefits
Most have lower out-of-pocket costs than Original Medicare
You may have to use certain healthcare providers
You don’t need a Medicare Supplement plan
Very little paperwork

MEDICARE ADVANTAGE CHOICE - HMO

Defined network of providers.
Primary Care Physician (PCP) coordinates all of your care.
You may have to receive a referral from your PCP to see a specialist.
In most cases, you must use network providers for all scheduled care.
No coverage for out-of-network care, except for emergency or urgent care.
Out-of-pocket costs may be significantly lower.

PREFERRED PROVIDER ORGANIZATION - PPO

Defined network of providers.
No referral needed to see any doctor
Flexibility to use providers who aren’t part of the network
Out-of-pocket costs may increase significantly when you use out-of-network providers, except for emergency or urgent care
You may save more when you use network providers because the plan pays a larger share of the cost

PRIVATE-FEE-FOR-SERVICE - PFFS

A Medicare Advantage Private-Fee-for-Service plan works differently than a Medicare Supplement plan.
We have network providers – providers who have signed contracts with our plan – for all services covered under Original Medicare
in our fully networked plans.
For partial network plans, contracted providers are limited to certain Durable Medical Equipment, home health providers, and some freestanding labs and hospitals. These providers have agreed to see members of our plan.
If you’re able to obtain covered services from network providers, you may pay less – even if your coinsurance is the same
for both in- and out-of-network services.

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