Medicare Health Maintenance Organization (HMOs)
Preferred Provider Organizations (PPO)
Private Fee-for-Service Plans
Medicare Special Needs Plans
MA Plans are provided by private companies and always cover emergency and urgent care. They are required to cover all that Original Medicare covers, except hospice care. MA Plans also offer extra coverage, including vision, hearing, dental and/or health and wellness.
Medicare Advantage Cost Considerations
Each MA Plan must follow Medicare rules but each plan can have unique out-of-pocket costs and rules of service, such as:
- Whether the plan charges a monthly premium in addition to your Part B premium.
- Whether the plan pays any of the monthly Part B premium. Some plans offer this option, usually for an extra cost.
- Whether the plan has a yearly deductible or any additional deductibles.
- How much you pay for each visit or service (copayments).
- The type of health care services you need and how often you get them.
- Whether you follow the plan’s rules, like using network providers.
- Whether you need extra coverage and what the plan charges for it.
- Whether the plan has a yearly limit on your out-of-pocket costs for all medical services.
Important Note: Medicare and Medigap
If you join a Medicare Advantage Plan, your Medigap policy won’t work. This means it won’t pay any deductibles, copayments, or other cost-sharing under your Medicare Health Plan. Therefore, you may want to drop your Medigap policy if you join a Medicare Advantage Plan. However, you have a legal right to keep the Medigap policy.