Medicare Advantage insurance plans offer benefits that aren't available through Original Medicare Part A and Medicare Part B plans. Medicare Advantage plans are offered through private insurance companies and can be customized for your own unique needs. There are two common types of Medicare Advantage plans, Preferred Provider Organizations (PPOs) Medicare Advantage plans and Health Maintenance Organizations (HMOs) Medicare Advantage plans.

 

The important difference between the Medicare Advantage plans is where you can get covered treatment. A Preferred Provider Organization Medicare Advantage plan has what is commonly referred to as a network of coverage. This means that there is a network of preferred facilities and physicians that are pre-approved for coverage with your Medicare Advantage plan. As long as you stay within this Medicare Advantage network, you will not incur any unexpected costs from covered procedures and examinations.

 

A Health Maintenance Organization Medicare Advantage plan operates in a slightly different way. HMO Medicare Advantage plan's also have a network of pre-approved service providers that will be covered within your Medicare Advantage plan, however the one main difference is that you must elect a primary care physician. This primary care physician acts as your personal doctor, but also as your healthcare coordinator. If you ever needed to see a specialty doctor who was not in your Medicare Advantage HMO plan network, your primary care physician could offer you a referral if they deemed it necessary.

 

With this referral, your Medicare Advantage insurance will cover a share of the costs but without it you can expect to pay full price. By knowing what doctors are important to your healthcare, you can make a much more informed decision about what Medicare Advantage plan will serve you best.