What Types of Medicare Advantage Plans Are There

trying to wrap your head around this medicare advantage thing you've probably noticed that there are different types of medicare advantage plans the most common types of medicare advantage plans might seem familiar to you if you've had group health insurance before for example take health maintenance organizations or hmos sound familiar this type of plan typically has a provider network usually you'll have to get your care from a provider in that network you will also have to choose a primary care provider

you will need to get referrals from the primary care provider to see a specialist then there are preferred provider organizations or ppos this type of plan might also have a provider network usually you don't have to get your care from a network provider but you generally have a higher co-payment or co-insurance if you go out of network and you don't have to choose a primary care provider you don't generally have to get referrals from the primary care provider to see a specialist another kind of medicare advantage plan

you might want to know about is a private fee for service plan or pffs one unique feature of this type of plan is its flexibility you might have the option of choosing a provider network or staying independent of a network with a pffs plan that has a provider network you won't have to check every time to see if your doctor accepts the plan's payment terms providers in the network have agreed to the plan's terms and to treat you you can also see doctors outside the network but you have to check to make

sure they accept the plan's terms on the other hand with a pffs plan without a provider network you have the freedom to choose any doctor you want however you will need to check with each provider before every visit to make sure they accept the plan's payment terms then there are special needs plans or smps this is a special type of medicare advantage plan that's tailor-made for a certain kind of health condition you might qualify for an snp if you live in a nursing home or need nursing care at home or if you

have an illness such as diabetes mellitus hiv aids stroke cancer or dementia there are many other illnesses that may qualify you for an smp in most cases you'll need to see doctors and specialists in the plan's provider network your plan will typically coordinate your care navigating through different medicare plans can be complicated at ehealth we are here to help if you have questions check our website at ehealthmedicare.com

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