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Different Types of Medicare Advantage Plans

Medicare Advantage is a type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits.

Medicare Advantage Plans include the following:

Health Maintenance Organization (HMO) Plan

In most HMO Plans, you can only go to doctors, other health care providers, or hospitals on the plan's list except in an emergency, for out-of-area urgent care or for temporary out-of-area dialysis. You may also need to get a referral from your primary care doctor to see other doctors or specialists. Find and compare HMO Plans in your area.

 

Preferred Provider Organization (PPO) Plans

A Medicare PPO Plan is a type of Medicare Advantage Plan (Part C) offered by a private insurance company. In a PPO Plan, you pay less if you use doctors, hospitals, and other health care providers that belong to the plan's network. You pay more if you use doctors, hospitals, and providers outside of the network.

Private Fee-for-Service (PFFS) Plans

A Medicare PFFS Plan is a type of Medicare Advantage Plan (Part C) offered by a private insurance company. PFFS plans aren’t the same as Original Medicare or Medicare supplement. The plan determines how much it will pay doctors, other health care providers, and hospitals, and how much you must pay when you get care.

Medicare Special Needs (SNP) Plans

Medicare SNPs are a type of Medicare Advantage Plan (like an HMO or PPO). Medicare SNPs limit membership to people with specific diseases or characteristics, and tailor their benefits, provider choices, and drug formularies to best meet the specific needs of the groups they serve. 

Find out who can join a Medicare SNP

 

Chronic Condition SNP (C-SNP) Plans

People who have specific severe or disabling chronic conditions (a few examples include - diabetes, End-Stage Renal Disease (ESRD), chronic heart failure, COPD, or dementia). Plans may further limit membership to a single chronic condition or a group of related chronic conditions. Plans usually are required to verify your condition(s) with your medical providers during the first 60 days of enrollment.

These definitions are directly from www.medicare.gov

By contacting the phone number on this website you will be directed to a licensed insurance agent.

Medicare Education
  • Medicare Simplified
  • Are You Eligible for Medicare?
  • Medicare: What you need to know
  • Different Types of Medicare Advantage Plans
  • Medicare Advantage Plans
  • Part D Prescription Drug Plans
  • Compare Medicare Supplement plans side by side
  • What is Medicare Supplement (Medigap) Insurance?

Maine Senior Insurance LLC

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Our agency is staffed by licensed, certified, insurance professionals committed to providing our clients with highly personalized service. Our staff are licensed in Florida, Georgia, North Carolina, Maine, and New Hampshire. Member of National Ass'n of Business Insurance Professionals Maine Chapter.

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The agents and agency are not affiliated with nor endorsed by any government agency. Not associated with the Federal Medicare program. By contacting us, you may be offered insurance policies to purchase. This is a solicitation for insurance plans by a licensed insurance agent/producer. Per CMS requirements, all calls to our 800# are recorded. Our agency does not offer every plan in every state, in which we are licensed. Our agency represents 10 carriers offering approximately 500 MAPD and 14 PDP plans, in those states. Please contact Medicare.gov, 1-800-MEDICARE, or your State Health Insurance Program (SHIP), to get information on all of your options.

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