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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

By contacting the phone number on this website you will be directed to a licensed insurance agent.

Medicare Advantage (Part C)
  • Medicare Advantage Plans
  • Different Types of Medicare Advantage Plans

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Submitting information or calling numbers listed on this website will direct you to a licensed Agent/Broker.

Important disclosures about Medicare Plans: Medicare has neither endorsed nor reviewed this information. Mountaintop Insurance Solutions is not connected to the Federal Medicare Program. This is a solicitation for insurance.

“Currently we represent 6 organizations which offer 15 products in your area. You can always contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program for help with plan choices.”*Please note that the above statement is a compliance requirement by CMS and pertains solely to Medicare Advantage and prescription drug plans. In simpler terms, my primary service area is Central Oregon and I am certified to help you enroll in any Medicare Advantage or prescription drug plan offered in Central Oregon.

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