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Medicare Advantage

Medicare Part C, otherwise known as Medicare Advantage, is an all-in-one alternative to Original Medicare (Part A and Part B). It provides additional benefits and coordinates healthcare to lower your overall out-of-pocket insurance costs. Here are the four distinct Advantage plans broken down to help you better understand your Medicare options.

Special Needs Plans (SNPs)

Special Needs Plans (SNPs) are available to those who qualify for both Medicare and financial help. For example, if you are eligible for Medicaid, you may also be eligible for a dual-eligible Special Need plan (D-SNP). These plans provide many fantastic benefits, including $0 monthly premiums, transportation benefits, and Part D coverage. Other features of this plan include:

  • Requires in-network care unless there is an emergency or out-of-area dialysis is required
  • Offers full prescription drug coverage
  • Most require a primary care doctor
  • Check for limited membership requirements

Preferred Provider Organization (PPO) Plans

PPO plans are another Medicare Advantage option. Compared to other options, this plan is one of the most flexible options, but at a slightly higher cost. It is useful for those who want to avoid the hassle of a primary care doctor for regular care. This plan’s primary features are that it:

  • Allows for out-of-network visits
  • Most cover prescription drugs
  • No primary care doctor required
  • Does not require specialist referrals

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Health Maintenance Organization (HMO) Plans

Health Maintenance Organization (HMO) Plans are one of the least expensive Advantage plans, at the cost of the flexibility of other options. For a low-cost, consistent plan, this is a great option. Its main features include:

  • In-network care except for emergency visits, out-of-area urgent care, or out-of-area dialysis
  • Most cover prescription drugs
  • Most require you to choose a primary care doctor and receive a referral to see a specialist

Private-Fee-for-Service (PFFS) Plans

Private-fee-for-service plans allow you to have more control over your care coordination and costs. When you need healthcare, you have the option to negotiate the insurance cost and coverage with the provider, making it an especially great option for those who travel frequently. Its primary features include:

  • Allows out-of-network care as long as the plan’s terms are accepted
  • Prescription drug coverage depends on the provider
  • Does not require a primary care doctor
  • Does not require specialist referrals
Compare Your Medicare Options with Help From the Experts

All of these Medicare Advantage plans are great options—but which plan is right for you? We will work with you to understand your healthcare needs and find the plan that best suits you. When you’re ready for your free consultation, call World Financial Advantage at 281-639-7787.