Finding the right Medicare Advantage Plan is not easy on your own. Medicare is beyond complicated. According to Washington Post columnist Thomas Heath, "There are also things to know upfront. This is not easy stuff, and the stakes are high. You can make big mistakes, potentially putting your life on the line."
The complexity of Medicare is one of the many reasons you should seek guidance from a Medicare Advantage Broker. A Medicare Advantage broker understands the complicated components of choosing the right plan and works directly for you. Let's take a look at the four basic plans that are available through Medicare Advantage.
1. Health Maintenance Organization (HMO) Plans
The Health Maintenance Organization (HMO) plans offer a wide range of healthcare services, including prescribed drugs, regular check-ups, and other medical services. However, certain areas such as emergency care, out-of-area urgent care, and out-of-area dialysis are not covered by HMO plans. You may also need to choose a primary doctor for your HMO plan, and if your doctor leaves the plan, you will be notified. With the Medicare HMO plan, you can also have access to yearly screening mammograms.
2. Preferred Provider Organization (PPO) Plans
This type of insurance policy is a bit different from HMO plans. Preferred Provider Organization (PPO) Plan offers a more robust health care service. In this plan, Medicare pays a sum of money to private insurance companies to offer health services to people in Medicare. With the Medicare PPO Plan, you won’t need to register a primary doctor. You can easily make use of the network of doctors or hospitals provided by Medicare. Additionally, you can use any hospital or doctor of your choice for a higher price. The Medicare PPO Plan also offers insurance coverage on prescription drugs, vision and hearing screenings, disease management, and other services that are not covered by HMO plans.
3. Private Fee-for-Service (PFFS) Plans
Another excellent health insurance policy offered by Medicare Advantage is the Private Fee-for-Service (PFFS) Plans. Private insurance companies provide this type of insurance policy. Depending on the variety of PFFS plans, you can choose doctors and hospitals both within and outside the Medicare network. Prescribed drugs are also covered, and a primary care doctor is not needed. Unlike the HMO and PPO Medicare plans, PFFS covers all emergencies. Furthermore, you will have access to other health benefits and programs.
4. Special Needs Plans (SNPs)
Medicare Special Needs Plan (SNPs) are similar to HMO and PPO plans; however, they only cover members with specific diseases such as diabetes, End-Stage Renal Disease (ESRD), HIV/AIDS, chronic heart failure, or dementia. In this plan, you must get your care from the Medicare network of doctors and hospitals, and a primary care doctor may be required. This health insurance plan also covers prescription drugs, yearly screenings such as mammograms, in-network pap tests, and pelvic exams.
If you have more questions about Medicare Advantage or would like a free consultation with a Medicare Specialist please contact us or email us at contact@medicaremessengers.com.
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