What are the types of Medicare Advantage plans?

Answered by 8 licensed agents

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

Answered by Holt Rushing on June 30, 2025

Broker Licensed in MS, AK, AL & 29 other states

Answered by Holt Rushing Medicare Insurance Agent
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)

Answered by Justin Call on June 30, 2025

Broker Licensed in UT, ID, MT & WY

Answered by Justin Call Medicare Insurance Agent
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
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:

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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 Fred Manas Medicare Insurance Agent
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
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!

Answered by David Treadway on June 30, 2025

Agent Licensed in OH, IN, KY & MI, SC, TN & VA

Answered by David Treadway Medicare Insurance Agent

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