Overview of 3 main Medicare Advantage Plans

Medicare HMO

Coordinated care plans in which you will choose a primary care doctor in the network. You usually must get a referral from that doctor before you can see a network specialist.

Medicare PPO

A type of coordinated care plan, but many PPO plans allow you to see any doctor in the network at your own choosing. This means that a referral is not always required.

Medicare PFFS

(Private-Fee-for-Service) plans generally have no network or a very small network. The company will allow any doctor to bill the plan as long as they agree to the plan’s terms and conditions up front. This puts the burden on you to ask your providers whether they will accept the plan before you seek medical services.

Less common Medicare Advantage Plans

Special Needs Plans (SNPs)

Available only to Medicare beneficiaries with certain health conditions. The plans are designed to address those health needs with special providers and drug formularies that are most suitable for people with those conditions.

Medical Savings Account Plans (MSAs)

These plans offer a health savings account alongside the insurance benefits. Medicare itself will put a set amount of funds into your account each year. You may spend those dollars whenever you access qualifying health services.