![]() ![]() The HMOPOS is a hybrid plan of the traditional HMO and PPO plans. Typically, people who have both Medicaid and Medicare, living in a nursing home or assisted living home, and or have more serious reoccurring medical conditions will choose these plans. The SNP plans are true to their name, for people with special medical needs. Most PFFS plans have been replaced with PPO plans nationwide. These Medicare Advantage plans are each very different and based on the one you choose, it will determine how much of the cost you will be responsible for. The PFFS plans are very similar to Original Medicare, in the fact you can go to any doctor, hospital or specialist that will accept the plans payment terms. However, unlike HMO, you are allowed to use out of network doctors, hospitals and specialists, at a higher cost. There are in network doctors, hospitals and specialists that cost less if you use them. The PPO plans are very similar to the HMO plans. Preferred Provider Organization Plans (PPO) You may also need to get a referral from your primary physician for specialized tests and to see additional doctors or specialists. Medicare Advantage plans that use this type of network follow these same guidelines. Traditional HMO plans only allow you to go to doctors, medical providers and hospitals within the HMO plans network. Health Maintenance Organization Plans (HMO) Medigap almost always automatically cuts a check to providers after Medicare pays its share. You pay deductibles and Co-pays directly to providers. You must buy a separate Part D plan for this. First six months after you sign up for Part B and are at least 65 years old. When you first enroll in both Medicare A and B and annually thereafter during Open Enrollment (Oct.15 – Dec.7). PPO: Any provider, but out-of-network providers cost more.Īny Provider that participates in Medicare. Very Low Cost to None (excluding the monthly premium) In-network medical deductibles and co-pays of $5,000 up to $7,500 a year, depending on the plan. Can vary by age, health history, or Company. Anyone enrolled will pay the same no matter of age or health history.Īverage of about $125 to $225 a month. $0 to more than $100 a month depending on the plan. Private gap coverage that pays all or most Part A & B out-of-pocket expenses. Private health plan that provides Part A & B benefits directly in place of Regular Medicare. ![]() In Relation to Original Medicare Parts A & B Preferred Provider Organization Plans (PPO).Health Maintenance Organization Plans (HMO).MA Plans are offered by private companies that contract with Original Medicare to provide all of your health insurance coverage. Second, you can choose a Medicare Advantage Plan which are also known as MA Plans or Medicare Part C. You have two choices when it comes to the Medicare programs offered.įirst, you can choose Original Medicare which includes Medicare Part A (Hospital coverage) and Medicare Part B (Doctor coverage). We will review all of the Medicare Advantage Plans and the positives and negatives of each plan option. Taking ten minutes to thoroughly read this article should help alleviate the confusion regarding Medicare Advantage aka Medicare Part C. Whether you choose Medicare Advantage Plans one of the Medicare parts or Medicare Supplement Plans, sorting through the options can be very confusing and frustrating. ![]()
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