![]() SNPs are different from their counterparts because they limit membership to serve specific groups of people with certain conditions or diseases. Note: To learn more about PPO plans, visit this source. Due to this, patients have more flexibility when it comes to care as they are in charge of who they see, when they see them, and why. However, unlike an HMO plan, a PPO plan does not require a PCP. Similar to an HMO plan, a PPO Medicare Advantage plan provides patients with a network of providers and practices they can visit. Preferred Provider Organizations (PPO) Plan Note: To learn more about HMO plans, visit this source. One of the advantages of an HMO plan is that they often have lower monthly premiums in comparison to competing plan types. Due to this PCP stipulation, it’s also necessary for patients to request referrals if they want or need to see an out-of-network specialist. This type of Medicare Advantage plan requires its patients to have a primary care provider (PCP) that coordinates their care. Health Maintenance Organizations (HMO) PlanĪ Medicare Advantage HMO plan provides a network of health care providers and practices that patients can visit. To learn more about these Medicare Advantage plan types, visit this source. Note: Less common plans include HMO Point of Service (HMOPOS) plans and Medicare Medical Savings Account (MSA) plans. The Federal Medicare Program lists various plan types including: Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), Special Needs Plans (SNP), and Private Fee-For-Service (PFFS). For more information about Medicare including a complete listing of plans available in your service area, please contact the Medicare program at 1-800-MEDICARE (TTY users should call 1-87) or visit Medicare has neither reviewed nor endorsed this information.When a patient enrolls in a Medicare Advantage Prescription Drug plan, they must decide which plan type they desire. Each Blue Cross Blue Shield company is responsible for the information that it provides. To find out about premiums and terms for these and other insurance options, how to apply for coverage, and for much more information, contact your local Blue Cross Blue Shield company. Enrollment in these plans depends on the plan’s contract renewal with Medicare. Medicare Advantage and Prescription Drug Plans are offered by a Medicare Advantage organization and/or Part D plan sponsor with a Medicare contract. Plans are insured and offered through separate Blue Cross and Blue Shield companies. Viewing this Medicare overview does not require you to enroll in any Blue Cross Blue Shield plans. Medicare overview information on this website was developed by the Blue Cross and Blue Shield Association to help consumers understand certain aspects about Medicare. No deductibles, copays or coinsurance are required for Medicare-covered preventive care services, such as annual wellness visits and mammograms for women. You pay 20 percent for some medical services, such as doctor services, outpatient therapy and durable medical equipment. You must first meet an insurance deductible before Part B helps with your medical costs.Ī copayment or cost sharing may apply to specific services, such as those received in an outpatient hospital setting. ![]() It is separate from the health insurance premiums you will pay if you choose Medigap, Medicare Advantage (Part C) or Prescription Drug Coverage (Part D). ![]() This premium is commonly paid through Social Security withholdings. Medicare Part B has a monthly insurance premium that is based on when you enroll and your annual household income. Medicare Part B covers doctor visits, durable medical equipment, speech therapy, occupational therapy, physical therapy, and other outpatient services.
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