What are the types of Medicare Advantage plans?

Question

Terri Reagin · Accepted Answer

There are PPO's, HMO's, PFFS and MSA's to name a few. Typically there are many to choose from. I recommend you speak with your local agent about your particular needs to help narrow choices.

Ben Washington · Answer

What are the types of Medicare Advantage plans? Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), HMO-POS(point of Service), Medicare Saving Plan MSA, Chronic Special Need Plan(SNP) C-SNP, Dual Eligible D-SNP

Answered by Ben Washington on June 30, 2025

Broker Licensed in IL, FL, MN, SC, TX & WI

Answered by Ben Washington Medicare Insurance Agent

Edward Smith, ChFC, CRPS, AIF · Answer

There are Medicare Advantage plans that use PPO Networks and HMO networks. PPO networks are larger and offer in and out of network coverage, although you will incur a higher out of pocket cost for out of network services. HMO plans offer in network coverage only except in the case of emergency care and some other limited situations. In some states there are PFFS (Private Fee for Service) plans. These plans allow you to go to any doctor that accepts original Medicare and is willing to accept the PFFS plans terms and conditions. I hope this helps.

Answered by Edward Smith, ChFC, CRPS, AIF on June 30, 2025

Broker Licensed in OH, GA, IN, KY & SC

Answered by Edward Smith, ChFC, CRPS, AIF Medicare Insurance Agent

Holt Rushing · Answer

There are a couple different ones, and it also depends on your area. Plans such as AARP, Humana, Aetna, Devoted, Cigna and Wellcare.

Justin Call · Answer

The most common types are below:
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)

Jane Ahrens · Answer

There are several types of Medicare Advantage plans including HMOs, PPOs, PFFSs and MSA plans. There are plans called MA only (those without a Part D) and those called MAPD (which include Part D). There are also plans tailored to specific populations and these are referred to as Special Needs Plans (SNPs). They include such plans as CSNP (for those with chronic conditions), DSNP (for those who have both Medicare and Medicaid), and ISNP (for institutionalized individuals). A good agent can help you choose the plan that is best suited for your needs.

Answered by Jane Ahrens on June 30, 2025

Broker Licensed in NY, AL, AZ & 16 other states

Answered by Jane Ahrens Medicare Insurance Agent

Jim Willis · Answer

There are both HMO‘s and PPO‘s. The HMO uses a fixed network and requires a referral to go out of that network.  The PPO does not need a referral to go out of the fixed network. 
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

Brandon Grzywa · Answer

Medicare Advantage plans usually fall into three categories:

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.

Fred Manas · Answer

Medicare Advantage plans, also known as Medicare Part C, are offered by private companies approved by Medicare and provide an alternative to Original Medicare. There are several types of Medicare Advantage plans, including Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), Private Fee-for-Service (PFFS) plans, and Special Needs Plans (SNPs). 
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:
.
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.

Vachik Chakhbazian · Answer

There are several types of Medicare Advantage plans, including Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), Private Fee-for-Service (PFFS) plans, and Special Needs Plans (SNPs)

Answered by Vachik Chakhbazian on June 30, 2025

Agent Licensed in CA, AL, AR & 22 other states

Answered by Vachik Chakhbazian Medicare Insurance Agent

Glenn Alterman · Answer

There are plans for every one

Regulars with no chronic issues 
Plans specifically focusing on certain issues 
Dual plans for Medicare and Medicaid

Angel Feliciano · Answer

Under Original Medicare, mental health services, including therapy, are covered, but there are specific details to be aware of:

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!

David Treadway · Answer

There are many types of Medicare Advantage plans so hang in there and I'll try to give you the main categories. 

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!

What are the types of Medicare Advantage plans?

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What are the types of Medicare Advantage plans?

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Seniors: Ask a Question of Your Own

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A non-government resource website