Medicare Advantage plans may offer additional benefits that may not be available through Medicare Parts A and B. Medicare Advantage plans are offered through private insurance companies and can be customized for your own unique needs. There are different types of Medicare Advantage plans: Preferred Provider Organizations (PPOs), Health Maintenance Organizations (HMOs), Private Fee-for-Service Plans (PFFS), Special Needs Plans (SNP), Medicare Medical Savings Account Plans (MSA) and HMO Point of Service Plans (HMOPOS).
One important difference between them is where you can get covered treatment. A Preferred Provider Organization has what is commonly referred to as a network of coverage. This means that there is a network of preferred facilities and physicians that are pre-approved for coverage with your plan. As long as you stay within this network, you will not incur any unexpected costs from covered procedures and examinations. The Medicare Advantage Plan you choose can also make a difference in your out-of-pocket costs and have may have different rules for how you get certain services like whether you need a referral to see a specialist.
Health Maintenance Organizations have a network of pre-approved service providers that will be covered within your plan, however, one main difference is that in most cases you must select a primary care physician. This primary care physician acts as your personal doctor, but also as your health care coordinator. If you ever needed to see a specialty doctor who was not in your HMO plan network, your primary care physician could offer you a referral if they deemed it necessary. You may need to obtain a referral from your primary care physician in order for the service to be covered.
By knowing what doctors are important to your healthcare, you can make a much more informed decision about what plan will serve you best. Find more information on the different Medicare Advantage Plan options at Medicare.gov.