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Are you looking for a Medicare Advantage plan? The Centers for Medicare & Medicaid Services reported that 21,327,223 people were enrolled in Medicare health plans such as Medicare Advantage nationwide, as of July 2018. That’s more than a third of all Medicare beneficiaries. It’s a good idea to go into your search well-informed so you can choose the best Medicare Advantage plan for you.
Medicare Advantage plans are available from private insurance companies that contract with Medicare to give you your Medicare Part A and Part B benefits. Some Medicare Advantage plans offer benefits beyond the Part A and Part B benefits, such as routine dental care or even acupuncture.
So before you decide which Medicare Advantage plan is best for you, you might want to learn about the different types of these plans.
Medicare Advantage Health Maintenance Organization (HMO) plans generally limit you to health-care providers within the plan’s network. These plans may often have lower premiums than other types of Medicare Advantage plans. You typically need to select a primary care physician for referrals and to help coordinate your care.
Medicare Advantage Preferred Provider Organization (PPO)* plans generally have provider networks, but let you get care from out-of-network doctors – often with a higher coinsurance or copayment. You usually don’t have to select a primary care physician, and you generally don’t need referrals to see specialists.
Medicare Advantage Health Maintenance Organization-Point of Service (HMOPOS) plans generally have provider networks, but let you get services outside the network. There may be a higher copayment or coinsurance when you go out-of-network.
Medicare Advantage Special Needs Plans (SNPs) are designed around certain health conditions, such as chronic heart failure or diabetes mellitus. In most cases, you need to:
SNPs include prescription drug coverage. You need to meet certain criteria to qualify for an SNP. If you have a health condition, you might want to call Medicare to see if you’re eligible for an SNP. You can reach a representative 24 hours a day, seven days a week at 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.
Medicare Advantage Private Fee-for-Service (PFFS)** plans generally set their own payment terms with health-care providers. You might have your choice of which doctor to see, as long as your doctor accepts Medicare assignment and the PFFS plan’s payment terms. Some PFFS plans have provider networks. You usually don’t have to select a primary care physician, and you generally don’t need referrals to see specialists.
Trying to decide which is the best Medicare Advantage plan for you? It may help to go through the questions below. And remember, it’s not only the type of Medicare Advantage plan that matters. You may also want to compare plan costs and other details to find the plan that may suit your needs.
Here’s an easy, quick way you can compare Medicare Advantage plans with no obligation. Just enter your ZIP code in the box on this page and click Browse Plans anytime you’d like.
You’ll see a list of plans in your area, with details about each (such as the monthly premium). You can enter your doctor’s name and prescription medications. If you see a plan that seems like the best Medicare Advantage plan for you, you can click Enroll to apply for the plan.
Here are a couple of quick things to know about Medicare Advantage plans.
Would you like to learn more about Medicare Advantage plans? You can get personalized assistance from a licensed eHealth insurance agent by contacting us today.
*Out-of-network/non-contracted providers are under no obligation to treat Preferred Provider Organization (PPO) plan members, except in emergency situations. For a decision about whether the plan will cover an out-of-network service, you or your provider are encouraged to ask for a pre-service organization determination before you receive the service. Please call the plan’s customer service number or see your Evidence of Coverage for more information, including the cost sharing that applies to out-of-network services.
**A Private Fee-for-Service plan is not Medicare supplement insurance. Providers who do not contract with the plan are not required to see you except in an emergency.
eHealth's Medicare website is operated by eHealthInsurance Services, Inc., a licensed health insurance agency doing business as eHealth. The purpose of this site is the solicitation of insurance. Contact may be made by an insurance agent/producer or insurance company. eHealth and Medicare supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. We offer plans from a number of insurance companies.