What are the two types of medicare advantage plans?

Below are the most common types of Medicare Advantage plans, Health Maintenance Organization (HMO) plans, Preferred Provider Organization (PPO) plans, Private Pay-Per-Service (PFFS) plans, and Special Needs Plans (SNP). Some Health Maintenance Organization plans have a point of service (POS) option, which allows you to use out-of-network providers for some health services. These plans are rather a hybrid between a health maintenance organization plan and a preferred provider organization plan. In general, you'll continue to have a primary care doctor and receive most of your health services through providers in the plan's network.

However, in some cases, you will have the option to leave this network, usually for a higher cost. Hopefully, you now have a better idea of the different types of Medicare Advantage plans and how they work. If you have questions about specific plan options that may be available in your service area, an eHealth licensed insurance agent will be happy to talk to you on the phone about your coverage needs; simply call the number on this page to get started. Or, if you prefer to search for plans now, enter your zip code in the plan search tool on this page to see plan options in your location.

Ask your current doctors if they participate in any Medicare Advantage plans or if they accept regular Medicare. If your plan doesn't include drug benefits, you are allowed to enroll in a separate Medicare prescription drug plan. Aetna offers three different Medicare Part D plans, with offers available throughout the United States. If you are currently enrolled in Original Medicare, Part A and Part B, you may be wondering about other ways you can expand your Medicare coverage.

An interactive flowchart to answer all your questions about navigating the Medicare enrollment process. Medigap is a private insurance option that is designed to work well with Medicare plans (Part A and Part B). An advantage of Medicare Advantage managed care plans is that care is coordinated and your primary care doctor will be aware of the specialists' findings. For example, if you have a chronic health condition, an SNP Advantage plan can help with your medical costs.

This means that your healthcare providers are actively communicating to coordinate your care between different types of health care services and medical specialties. While some Medicare Advantage plans offer long-term savings, plan flexibility, and better care, others may result in fewer provider options, additional costs, and lifestyle challenges. You can supplement this coverage with a separate Medicare Part D prescription drug plan and a Medigap supplemental insurance plan. As noted above, Original Medicare includes Part A (hospital insurance) and Part B (medical insurance).

Keep in mind that this is one of the rare cases where you are allowed to be in a Medicare Advantage plan and a Medicare prescription drug plan. Health Maintenance Organization (HMO): You may be familiar with this type of plan if you were ever covered by an employer through an HMO. With traditional Medicare, you don't need a referral to see a specialist or prior authorization for procedures, but you'll need to make sure that care is coordinated and that your doctors communicate with each other.

Elise Woehl
Elise Woehl

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