Different Types of Medicare Advantage Plans

How Health Maintenance Organization (HMO) Plans Work

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. You may also need to get a referral from your primary care doctor to see other doctors or specialists. 

How Preferred Provider Plans (PPO) Work

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.  You do not need a referral to see other doctors or specialists.

How Private Fee for Service Plans (PFFS) Work

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 Medigap. 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. 

How Medicare Special Needs Plans (SNP) Work

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.

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Source: www.medicare.gov