advantage plans + coverage: The availability of these plan types can vary by location, so it’s important to check which options are offered in your area. When choosing a Medicare Advantage plan, consider your healthcare needs, budget, and preferences, as well as the structure and network restrictions of the plan that best suits your individual circumstances. 1. HEALTH MAINTENANCE ORGANIZATION (HMO) PLANS HMO plans require you to choose a primary care physician (PCP) and generally restrict your healthcare services to a network of providers. You typically need referrals from your PCP to see specialists. Emergency care is covered outside the network. 2. PREFERRED PROVIDER ORGANIZATION (PPO) PLANS PPO plans offer more flexibility in choosing healthcare providers, both in and out of the plan’s network. You generally don’t need referrals to see specialists While costs are lower when using in-network providers, you can still receive some coverage for out-of-network care. 3. PRIVATE FEE-FOR-SERVICE (PFFS) PLANS PFFS plans determine how much they will pay for covered services, and you can see any Medicare-approved healthcare provider who agrees to their terms. Not all providers may accept PFFS plan terms, so it’s essential to confirm with the provider before receiving care. These plans may have a network for prescription drug coverage.
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