Medicare advantage plan, medicare advantage HMO plan, and ppo plan - differnce

What are Medicare Advantage plans?

Medicare Advantage plans are health plan options that are Medicare approved. If you join one of these plans, you generally get all of your Medicare-covered healthcare through that plan.

Medicare Advantage plans (called MA plans) combine Part A (hospital insurance) and Part B (medical insurance) together in one plan, and can also be combined with Medicare Part D prescription drug coverage (called MA-PD plans).


What are Medicare Advantage HMO plans?

Medicare HMO plans are a type of Medicare Advantage Plan that includes all your Part A (hospital insurance) and Part B (medical insurance) benefits. Medicare Advantage HMOs also cover additional benefits, like extra days in the hospital, and dental and vision care. With most Medicare Advantage HMOs, you can only go to doctors, specialists, or hospitals in the plan's network, except in an emergency or urgent care situation.

What are Medicare Advantage PPO plans?

Medicare Advantage PPO plans are a type of Medicare Advantage Plan that includes all Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) benefits. These plans are designed to reduce the cost of healthcare by contracting with certain doctors, labs, and hospitals to provide care at a discounted rate for members. A PPO plan has a list (called a "network") of physicians and other providers that members may go to. However, members have the flexibility to go to any doctors, specialists, or hospitals that aren't on the plan's list for similar or different costs, depending on the plan. Some plan options include the same costs for in and out-of-network benefits. Please use our Plan Finder to find plan costs in your area. With the exception of emergencies or urgent care, it may cost more to get care from out-of-network providers.

What are Medicare Advantage PFFS plans?
Medicare Advantage Private Fee-For-Service (PFFS) Plans are a type of Medicare Advantage Plan that includes all Medicare Part A (hospital insurance) and Part B (medical insurance) benefits. These plans give members the freedom to choose any doctor or hospital that accepts Medicare and the plan's terms and conditions.