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Different types of Medicare Advantage Plans




Did you know that there are different types of Medicare Advantage Plans? And that some plans have special requirements? This video will address the different types of Advantage Plans by looking at two specific topics: How different provider networks affect your care and why some plans are only for defined groups of people.




Which type of Medicare Advantage Plan is best for you?

Medicare Advantage Plans are often distinguished by their type of provider network. There are HMO, PPO, HMO-POS and PFFS plans. It’s important to note that you may not have all the different types of plans in your service area. HMOs for instance, are more popular in highly populated areas where it’s easier for insurance companies to put together a comprehensive network. While more rural areas may offer more PFFS plans.

When enrolling in a plan it’s important to review the plan’s Summary of Benefits, the Provider Network and the Part D Formulary. The provider network is especially important to review prior to enrolling. While some plans like an HMO will not cover non-emergency out -of-network care, others like a PPO will allow you to receive care out-of-network but you will often pay more in copays and coinsurance.

There are also plans that are meant for specific groups of people. These are known as Special Needs Plans (SNP). There are SNPs for people with chronic illnesses like diabetes or COPD, people confined to an institution such as a nursing home and plans for people who are dual-eligible. People are dual-eligible when they are enrolled in both Medicare and their State’s Medicaid program.