Perfecto © 2012: Privacy Policy

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NOTE:  

You need to choose a Medicare Prescription Drug plan if you will be enrolling in a Medicare Supplement Plan.  Most Advantage Plans include the prescription drug coverage. 

Advantage Plans

Medicare Advantage Plans, also referred to as Medicare Part C, are offered by private insurance companies and include the services of Medicare Part A (hospital insurance) and Medicare Part B (medical insurance), and most plans also include Part D (prescription drug coverage). An Advantage plan must provide coverage for all the same services covered by Original Medicare, including emergency care and urgent care. In addition, an Advantage plan has a yearly out-of-pocket maximum to provide a financial safety net. Medicare Advantage plans may also provide coverage for other services not included in Original Medicare such as routine dental, vision, hearing, and health and wellness programs.

 

To join an Advantage plan, you have to be eligible for Medicare, live in the area where the plan is offered, and have both part A and part B active. Plans vary in areas of service, by monthly premiums, provider networks and prescription drug coverage.

Different Types of Medicare Advantage Plans:  

 

Health Maintenance Organization (HMO)

In most HMO plans, you can only go to doctors and hospitals in the plan’s network, except in urgent or emergency situations.

 

Health Maintenance Organization – Point of Service (HMO-POS)

HMO-POS has a network of doctors and hospitals, however, they do have limited ability to go outside of the network, generally for higher costs, except in urgent or emergency situations.

 

Preferred Provider Organization (PPO)

PPO plans allow you to go outside of their network of doctors and hospitals, but it will generally cost you more in copays and coinsurance, except in urgent or emergency situations.

 

Private Fee For Service (PFFS)

PFFS plans generally allow you to go to any doctor that is willing to accept the terms of the plan, but the doctor may change their mind about accepting the plan at any time, even if you’ve seen them before, except in urgent or emergency situations.

 

Special Needs Plan (SNP)

SNP plans generally require you receive care from a network of doctors and hospitals, except in urgent or emergency situations. SNP plans also carefully manage and coordinate your care to make sure your special needs and orders are being treated and adhered to properly. Not all plans are available in all areas. SNP plans are for specific groups of people, such as those with Medicare and Medicaid, those that live in a nursing home, or those that are diagnosed with certain chronic, disabling conditions such as diabetes and heart disease.

Independent Insurance Brokers Specializing in Medicare Products

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