There are, in fact, six different MA plans outlined in the Medicare & You 2018 Handbook.
- HMO – Generally requires members to use a primary care doctor and obtain referrals for specialists; if a doctor leaves the network, you can choose another physician within the network. Covers prescription drugs in most cases. May have to pay full cost of services not in the network.
- PPO – Has a network of physicians and hospitals; does not require a referral for a specialist and allows out-of-network care for covered services, though typically at a higher cost.
- Private Fee for Service (PFFS) plans allow members to go to any Medicare-approved physician or hospital agreeing to treat you and accept the plan’s terms of payment
- Special Needs Plans (SNP) are limited to people in facilities such as nursing homes, who need home nursing care, or have certain chronic diseases. Generally requires use of network except in some emergency situations; must include Part D drug coverage
- HMO Point of Service (HMOPOS) allowing some out of network services, often at a higher cost
- Medical Saving Account (MSA) combining a high-deductible healthcare plan with a bank account; no Part D coverage
Read Next: Changing to a Medicare Advantage Plan
Learn more: What is the Medicare Advantage Open Enrollment Period?
Return to: Medicare Advantage
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