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Medicare Advantage

Medicare Advantage plans or “MA” plans are also called Part C. MA plans are available through private companies approved by Medicare. The insurance companies providing MA plans are under contract with Medicare and are paid by Medicare. The reason the private companies are paid is because they are paying your medical bills instead of Medicare. Rest assured: you are still part of Medicare with this type of plan, and still have all the same rights and protection.

There are three main types of Medicare Advantage plans: an HMO, PPO, or PFFS.

  • An HMO plan is the most restrictive plan. You may only go to doctors and hospitals that are in the provider’s network unless there is an emergency.
  • A PPO plan still has what they call “In Network” doctors and hospitals, but you are also allowed to go outside the network. If you go outside the network (known as “Out of Network”) you normally have higher co-pays or deductibles than you would if you would stay in the network.
  • A PFFS plan allows you to go to any doctor or hospital that would accept the MA plan’s terms and conditions. There is not a network with this type of plan. For the most part, PFFS plans were eliminated as of 2011.

Most Medicare Advantage plans provide lower premiums but higher co-pays and deductibles than a Medicare Supplement.

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