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Medicare Advantage Plans
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What is Medicare Advantage?
These health plans cover all the benefits of Medicare Part A, including hospital stays, skilled nursing care and home health care, but not hospice care (which is still covered by your Part A benefit). These plans also cover all the benefits of Medicare Part B, including doctor visits, outpatient care, screenings, shots and lab tests.
Many Medicare Advantage Plans also include Medicare Part D prescription drug coverage. Medicare Advantage plans work similarly to employer-sponsored health insurance plans that you may have had or currently have, which may help you continue a similar level of coverage to what you have now.
Medicare Advantage Plan Types:
HMO Plans-Health Maintenance Organization
- Typically requires you to receive services from a network of local providers; except for emergency room, urgent care visits and renal dialysis services.
- Often require referrals to specialists, depending on the plan.
- Out-of-pocket costs are typically lower than PPO and POS plans.
POS Plans-Point-of-Service
- Similar to an HMO plan, but you can also see providers for certain services outside the provider network; generally, at a higher cost.
- Referrals to specialists may be required, depending on the plan.
- Out-of-pocket costs are typically higher than HMO plans, but lower than PPO plans.
PPO Plans-Preferred Provider Organization
- You can see providers for all covered services outside the provider network, generally at a higher cost.
- Don’t require referrals to specialists.
- Out-of-pocket costs are typically higher than HMO and POS plans.
Medicare continues to offer seniors and people with disabilities flexibility and choices while providing high quality healthcare services. Whether through Original Medicare (Parts A and B), Medicare Advantage, or the prescription drug benefit (Part D).
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