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Different Types of Medicare Advantage Plans

Medicare Advantage is a type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits.

Medicare Advantage Plans include the following:

Health Maintenance Organization (HMO) Plan

In most HMO Plans, you can only go to doctors, other health care providers, or hospitals on the plan's list except in an emergency, for out-of-area urgent care or for temporary out-of-area dialysis. You may also need to get a referral from your primary care doctor to see other doctors or specialists. Find and compare HMO Plans in your area.

 

Preferred Provider Organization (PPO) Plans

A Medicare PPO Plan is a type of Medicare Advantage Plan (Part C) offered by a private insurance company. In a PPO Plan, you pay less if you use doctors, hospitals, and other health care providers that belong to the plan's network. You pay more if you use doctors, hospitals, and providers outside of the network.

Private Fee-for-Service (PFFS) Plans

A Medicare PFFS Plan is a type of Medicare Advantage Plan (Part C) offered by a private insurance company. PFFS plans aren’t the same as Original Medicare or Medicare supplement. The plan determines how much it will pay doctors, other health care providers, and hospitals, and how much you must pay when you get care.

Medicare Special Needs (SNP) Plans

Medicare SNPs are a type of Medicare Advantage Plan (like an HMO or PPO). Medicare SNPs limit membership to people with specific diseases or characteristics, and tailor their benefits, provider choices, and drug formularies to best meet the specific needs of the groups they serve. 

Find out who can join a Medicare SNP

 

These definitions are directly from www.medicare.gov

Please feel free to contact us to be directed to a licensed insurance agent. We are here to help.

Medicare Coverage
  • Medicare Simplified
  • Medicare: What you need to know
  • Medicare Advantage Plans
  • What is Medicare Supplement (Medigap) Insurance?
  • Part D Prescription Drug Plans
  • Are You Eligible for Medicare?
  • Different Types of Medicare Advantage Plans
  • Compare Medicare Supplement plans side by side

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Utah
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(801) 316-8070

This is a solicitation for insurance. We do not offer every plan available in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.

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