Medicare Advantage

Medicare Advantage

Medicare Advantage Plans have networks of doctors, hospitals, and pharmacies. This type of plan is considered managed care and can be in the form of a Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), or Private Fee for Service (PFFS). HMOs have the most restrictive care as they do not have out-of-network coverage, unless in an emergency. PPOs have in and out-of-network coverage. With PFFS plans, you can see any doctor who will accept the terms and payments of the plan, but you must verify they will accept this every time you see them. These types of plans can include drug coverage and are called Medicare Advantage Prescription Drug plans.

Medicare Advantage (MA) and Medicare Advantage Prescription Drug (MAPD) Plans have the option to include services that Medicare doesn’t pay for, such as: vision, dental, hearing, over-the-counter medication reimbursement, and installation of certain durable medical equipment: ramps and handrails.

Some companies that offer these types of plans also have specialized coverage for individuals who have specific chronic conditions (CSNP) or are eligible for both Medicare and Medicaid (DSNP). The plans are structured to provide services and benefits specific to the needs of the individuals and their situations. You must meet certain qualifications and certifications to enroll in this type of plan.

To learn more about Medicare Advantage plans check out this informative video: What is a Medicare Advantage Plan?