There are different types of Medicare Advantage Plans:
- Health Maintenance Organization (HMO) Plan
- HMO Point-of-Service (HMO POS) Plan
- Preferred Provider Organization (PPO) Plan
- Private Fee-for-Service (PFFS) Plan
- Special Needs Plan (SNPs)
- Medical Savings Account (MSA) Plan
*Availability for these plans is dependent on your service area
Compare Medicare Advantage Plans Side-by-Side
* This is basic information about each type of Medicare Advantage Plan
| HMO | PPO | PFFS | SNP | MSA | |
|---|---|---|---|---|---|
| Premium Do most plans charge a monthly premium? | Yes Many charge a premium in addition to the monthly Part B premium | Yes Many charge a premium in addition to the monthly Part B premium | Yes Many charge a premium in addition to the monthly Part B premium | Yes Many charge a premium in addition to the monthly Part B premium | No You won’t have to pay a separate monthly premium, but you’ll continue to pay the monthly Part B premium |
| Drugs Does the plan offer Medicare drug coverage (Part D)? | Usually If you join an HMO Plan that doesn’t offer drug coverage, you can’t get a separate Medicare drug plan | Usually If you join a PPO Plan that doesn’t offer drug coverage, you can’t get a separate Medicare drug plan | Usually If you join a PFFS Plan that doesn’t offer drug coverage, you can get a separate Medicare drug plan | Yes All SNPs must provide Medicare drug coverage (Part D) | No You may join a separate Medicare drug plan |
| Providers Can I use any doctor or hospital that accepts Medicare for covered services? | Sometimes You generally must get your care and services from doctors, other health care providers, or hospitals in the plan’s network (except emergency or urgent care or out-of-area dialysis). In an HMOPOS Plan, you may be able to get some services out of network for a higher copayment or coinsurance | Yes Each plan has a network of doctors, hospitals, and other providers that you may go to. You may also go out of the plan’s provider network, but your costs may be higher | Yes You can go to any Medicare-approved doctor, other health care provider, or hospital that accepts the plan’s payment terms and agrees to treat you. If the plan has a network, you can use any of the network providers (if you go to an out-of-network provider that accepts the plan’s terms, you may pay more) | Sometimes If your SNP is an HMO, you must get your care and services from doctors or hospitals in the SNP’s network (except emergency or urgent care or out-of-area dialysis). However, if your SNP is a PPO, you can get Medicare-covered services out of network | Yes MSA Plans generally don’t have network providers. You may go to any Medicare-approved provider for services Original Medicare covers |
| Referral Do I need a referral from my doctor to use a specialist? | Yes | No | No | Maybe If the SNP is an HMO, you need a referral. If the SNP is a PPO, you don’t need a referral | No |
Source: Medicare.gov