If you are interested in a Medicare Advantage plan, you may want to learn more about the different types of plans. Two common plan types are Preferred Provider Organization (PPO) and Health Maintenance Organization (HMO).
A Medicare PPO Plan is a type of Part C Medicare Advantage plan. These plans are offered by private insurance companies that have contracted with Medicare. Through a PPO Plan, you are connected to a network of doctors, hospitals, and other health care providers. You pay less if you go to providers from within this network, but you can also get covered treatment at out-of-network providers. Though, out-of-network providers do incur a higher cost.
In PPO Plans, prescription drug coverage is offered most of the time. It might also be helpful to know that you don’t need a primary care physician when you have a PPO Plan.
Medicare HMO Plans are a type of Part C Medicare Advantage plan. These plans are offered by private insurance companies that have contracted with Medicare. HMO Plans have a strict network of providers that you can see. If you see providers from outside of this network, you will be responsible for the full cost of services you’ve received (unless it’s an emergency). That’s why it’s important to find an HMO Plan that works with providers you are interested in.
Most HMO Plans offer prescription drug coverage, and you need a primary care physician with these plans. To see a specialist, you must have a referral from your PCP in most situations.
Whether you should sign up for an HMO or PPO Plan depends on your health care needs. If you think it is likely that you’ll need to see out-of-network providers, a PPO Plan would be better. On the other hand, HMO Plans are generally lower out of pocket cost, than PPO Plans. If you don’t mind having a restricted network of providers, they are a great choice to save money.
You can purchase a Medicare Advantage Plan today if you are eligible and enrolled. If you need help finding the right plan, get help from an insurance broker. You can reach Duncan Market Insurance.