Medicare Advantage programs generally fall into a few different types. Here are the 3 most common types of Medicare Advantage programs:

 

Medicare Advantage HMO are private plans that the federal government pays to administer Medicare benefits. Like all Medicare Advantage Plans, Medicare Advantage HMOs must provide you with the same benefits, rights, and protections as Original Medicare, but they may do so with different rules, restrictions, and costs. Some HMOs offer additional benefits, such as vision and hearing care.

Medicare Advantage PPO  must provide you with the same benefits as Original Medicare but may do so with different rules, restrictions, and costs. PPOs can also offer additional benefits. PPO’s are generally more flexible than Medicare HMO plans. You are able see any doctor in the network without a referral. You can also treat outside the network, usually at a slight higher cost.

Medicare Advantage PFFS (Private-Fee-for-Service) plans is a type of Medicare Advantage plan offered by a private insurance company. PFFS plans aren’t the same as Original Medicare or Medicare Supplement plans. With a PFFS plan, the plan determines how much it will pay doctors, other healthcare providers and hospitals—and how much you must pay when you get care. PFFS generally have no network or a very small network. You can see any doctor who will bill the plan as long as they agree to the plan’s terms and conditions up front.

Special Needs Plans (SNPs) are available only to Medicare beneficiaries with certain health conditions. The plans are designed to focus on health needs with special providers and drug formularies that are most appropriate for people with certain health conditions. Most SNP plans are an HMO structure.

Medical Savings Account Plans (MSAs) offer a health savings account some with insurance benefits. Medicare itself will put a set amount of funds into your account each year. You are able to spend those funds whenever you access approved health services.

You can enroll in a Medicare Advantage plan during your Initial Election Period for Medicare also known as IEP. You can also enroll or dis-enroll from Medicare Advantage during the Annual Election Period. The Annual Election Period runs from October 15th thru December 7th of each year.

Theres are 2 exceptions to enroll in a Medicare Advantage plan, whereas, you do not need to enroll during the Annual Election Period (AEP:

  • If you just recently moved to Nevada from another state you can qualify and enroll in a plan the following month of your move. So, if you moved in April you can enroll and make your plan effective May 1st. You do not need to wait for the Annual Election Period (AEP) that runs from October 15 – December 7. Medicare gives you up to 63 days to make this change from the date you moved.
  • You may also enroll at anytime if you become eligible for Medicaid or the Part D Extra Help program. No need to wait for AEP to enroll.

At Nevada Medicare we can help you determine an election period – call us for a hassle-free help in understanding your rights and what’s available to you. Contact Us today.

Medicare Advantage plans operate in service areas. First, you must be enrolled in both Medicare Parts A and B. Then you must live in the plans’ service area.

At Nevada Medicare we can make it easy for you and show you the plans available in your area – call us for a hassle-free help in determining what’s available to you. Contact Us today.