What is a Medicare Advantage Plan

The Medicare Advantage plan is also known as Medicare part C. This Medicare plan is offered to men and women who are eligible for Original Medicare. Original Medicare includes Medicare plans part A and part B.  It is a private insurance option for those who do not want Medicare plan part A or Medicare plan part B. When a person joins the Medicare Advantage plan, they are still a part of the Medicare program. One of the main differences is this a private insurance option and is not paid for by the Original Medicare.

There are three types of the Medicare Advantage plan. These types include PFFS, PPO and HMO. Other Medicare part C options include special needs plans, medical savings account plan and the HMO point of service plan.

The Medicare Advantage PPO Plan

PPO stands for Preferred Provider Organization. There are two types of the Medicare Advantage Preferred Provider Organization plan. The regional PPO plan grants its members the freedom to choose between a provider that is out of Medicare Advantage network and a provider that is in the Medicare Advantage Network. This plan is designed to cover all benefits that are necessary to a person’s medical health regardless of the network. However, any medical services that are provided outside of the network tend to cost more than medical services that are provided in the network.

The national Medicare Advantage PPO plan provides more flexibility to its members. The cost of the healthcare does not change if the person receives medical care outside of the network. The national Medicare Advantage PPO plan is designed to replace group PFFS plans. This is because group PFFS plans are not offered by United Healthcare anymore. Federal regulation changes have made this so.

The Medicare Advantage HMO Plan

HMO stands for Health Maintenance Organization. Medicare Advantage Health Maintenance Organization plans are designed to offer coverage to plan members within a network. This is a network of doctors and hospitals that have been contracted locally. The Medicare Advantage HMO plan does not offer coverage if the medical service was provided outside of that plan’s network. However, the HMO plan does offer coverage to medical services provided outside of the plan’s network in emergency cases.

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