What are the types of Medicare Advantage plans?
Answered by 13 licensed agents
Answered by Terri Reagin on July 17, 2025
Broker Licensed in OK, AR, CO & 6 other states
Answered by Ben Washington on June 30, 2025
Broker Licensed in IL, FL, MN, SC, TX & WI
Answered by Edward Smith, ChFC, CRPS, AIF on June 30, 2025
Broker Licensed in OH, GA, IN, KY & SC
Answered by Holt Rushing on June 30, 2025
Broker Licensed in MS, AK, AL & 29 other states
MAPD - Medicare Advantage Plan with Drug Coverage
MA - Medicare Advantage Plan without drug coverage
HMO - In-network only plans
PPO - In-network and out-of-network plans
PFFS - Private Fee For Service (not very common)
Answered by Justin Call on June 30, 2025
Broker Licensed in UT, ID, MT & WY
Answered by Jane Ahrens on June 30, 2025
Broker Licensed in NY, AL, AZ & 16 other states
The HMO usually offers a few better benefits, but there is a drawback of needing a referral.
In addition, there are DSN P’s and CSNP’s for those who have Medicaid or special needs due to their health problems
Answered by Jim Willis on July 21, 2025
Broker Licensed in AZ, CA, CO & 12 other states
1) Standard MAPD plans. These plans are typically offered on a HOM PPO managed health platform and include Rx benefits.
2) Dual Eligible Plans (D-SNP): These plans are designed to work with your state Medicaid benefits.
3) MA only plans: These plans use HMO/PPO managed health plans. The majority is PPO. These plans DO NOT include RX benefits like a standard MAPD does. These plans are designed to be used in conjunction with VA or TRICARE benefits.
There are a few lesser-used Advantage plan options, such as Medicare Cost plans, Medicare Savings Plans, and C-SNP (chronic special needs plans), but these are not widely available or utilized.
Answered by Brandon Grzywa on July 21, 2025
Broker Licensed in NE, IA & SD
Here's a breakdown of the different types:
Health Maintenance Organization (HMO) Plans:
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These plans require you to choose a primary care physician (PCP) who coordinates your care. You'll generally need referrals to see specialists, and you'll typically need to stay within the plan's network of providers to have your care covered.
Preferred Provider Organization (PPO) Plans:
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PPO plans offer more flexibility than HMOs, allowing you to see specialists and out-of-network providers, though you'll usually pay more for doing so.
Private Fee-for-Service (PFFS) Plans:
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PFFS plans allow you to see any doctor who accepts the plan's payment terms. However, not all doctors may accept these terms, so it's crucial to check with your providers.
Special Needs Plans (SNPs):
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SNPs are designed for specific groups of people, such as those with certain chronic diseases, those who live in institutions, or those who are dually eligible for both Medicare and Medicaid.
Medicare Advantage plans often include additional benefits not offered by Original Medicare, such as prescription drug coverage, dental, vision, and hearing coverage. They also may have lower out-of-pocket costs for certain services compared to Original Medicare.
Answered by Fred Manas on June 30, 2025
Agent Licensed in NY, CT, DC & 7 other states
Answered by Vachik Chakhbazian on June 30, 2025
Agent Licensed in CA, AL, AR & 22 other states
Regulars with no chronic issues
Plans specifically focusing on certain issues
Dual plans for Medicare and Medicaid
Answered by Glenn Alterman on July 26, 2025
Broker Licensed in TX, AZ, CA & FL, NJ, OH & TN
1. **Coverage for Outpatient Mental Health Services**: Original Medicare (Part A and Part B) covers outpatient mental health services, which include individual and group therapy sessions provided by a licensed psychologist or psychiatrist.
2. **Cost-Sharing**:
- You typically pay 20% of the Medicare-approved amount for outpatient mental health services after you have met your Part B deductible.
- The deductible for Part B must be met before Medicare starts to pay its share.
3. **Inpatient Mental Health Services**: If you require hospitalization for mental health reasons, Medicare Part A will cover the costs of inpatient care after you meet the deductible. However, there are limits on the number of days covered in a psychiatric hospital (generally up to 190 days in your lifetime).
4. **Preventive Services**: Medicare also covers an annual depression screening as part of its preventive services, which may be beneficial for seniors.
5. **Limitations**: It's important to note that while many mental health services are covered, not all types of therapy or providers may be included. Always check if the provider accepts Medicare and if the services you need are covered.
In summary, while therapy and mental health services are covered under Original Medicare, there are costs involved, and it’s essential to understand your financial responsibilities. If you have any further questions or need assistance navigating your Medicare options, feel free to reach out to us at Feliciano Fiduciary Services!
Answered by Angel Feliciano on July 28, 2025
Broker Licensed in NY, FL & OH
First, there are dual plans and non-dual plans, meaning those that also require a certain level of Medicaid and those that are available without.
Second, there are chronic condition advantage plans which require certain diagnoses to enroll in them (for example, diabetes or COPD).
There area also MA only advantage plans, which mean they do not including Rx or PDP (prescription drug coverage).
Finally, there a categories of advantage plans based on what kind of network they adhere to (for example, HMO- must use the network unless an emergency, PPO- you pay the lowest cost in network but you can go anywhere so long as the provider accepts it, PFFS- private fee for service, also network based but flexible, POS- point of sale, allow for some out of network coverage.
Some of these can be combined (for example, you could have an MA only PPO or a dual PPO (also known as DSNP). The dual plans and chronic plans are also known as SNPs or Special Needs Plans.
Great questions because knowing how your plan may limit your access or enable flexibility is important to know, especially in an environment where we are seeing a bit of tightening in the network acceptance of the most restrictive plans (HMOs).
I hope this response is useful to your and others. Good luck in your Medicare years!
Answered by David Treadway on June 30, 2025
Agent Licensed in OH, IN, KY & MI, SC, TN & VA
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