How Medicare Plans Work
Medicare Health Plans (like HMOs and PPOs)
Medicare Advantage Plans are health plan options that are approved by Medicare but run by private companies. They are part of the Medicare Program, and sometimes called "Part C." When you join a Medicare Advantage Plan, you are still in Medicare. With Medicare Advantage Plans:
- Some of the plans require referrals to see specialists.
- In many cases, the premiums or the costs of services (co-pays and deductibles ) can be lower than they are in Original Medicare or Original Medicare with a Medigap policy. Medicare Health Plans charge different premiums and have different costs of services, so it is important to check with the plan before you join.
- The plans provide all of your Part A (hospital) and Part B (medical) coverage and must cover medically-necessary services.
- They often have networks, which means you may have to see doctors who belong to the plan or go to certain hospitals to get covered services.
- They generally offer extra benefits, and many include prescription drug coverage.
- In many cases, your costs for prescription drug coverage can be lower than in the stand-alone Medicare Prescription Drug Plans.
- Some of the plans coordinate your care, using networks and referrals, more than others. This can help manage your overall care and can also result in savings to you.
- You dont need to buy a Medigap policy.
Medicare Health Plans include:
Other Medicare Health Plans
There are some types of Medicare Health Plans that arent part of Medicare Advantage, but are still part of the Medicare Program. With these plans, you generally get all your Medicare-covered health care through that plan. Some plans cover prescription drugs.
Other Medicare Health Plans include: