![]() ![]() ![]() PFFS Medicare Advantage plans come with the most flexibility as they typically come with a network, but not always. Note: To learn more about Special Needs Plans, visit this source. In addition, like an HMO plan, SNPs require their patients to have a PCP or care coordinator, and it’s common for patients to require referrals for certain specialists. ![]() These qualifying membership factors include those that live in certain institutions such as nursing homes, those eligible for Medicare and Medicaid services, or those who have chronic disabling conditions (e.g., diabetes, End-Stage Renal Disease (ESRD), HIV/AIDS, chronic heart failure, or dementia). 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). When a patient enrolls in a Medicare Advantage Prescription Drug plan, they must decide which plan type they desire. ![]()
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