Medicare Advantage Plans are private insurance plans that help with gaps in Medicare coverage. You must enroll in Parts A & B & be current on Part B premium payments to qualify.
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Hello, and welcome to today's Medicare q&a, where I'll be giving a brief overview of the different Medicare Advantage plans. And if you have any questions as I'm going along, don't hesitate to let us know down in the comments below. We always love getting to help answer as many of those as we can. So let's start with Medicare Advantage. It's also known as part C. So you can interchange those names, they mean the same thing.

Medicare Advantage plans are private insurance plans. And they're designed to help with gaps in a person's Medicare coverage. So a gap would be something where you're not getting coverage for a specific health need. And that's where Advantage plans come in to help with that. So to be eligible for advantage enrollment, you must enroll in Medicare Parts A and Medicare Parts B. So you got to enroll in both of those. And you need to be current on your Part B premium payments. So you got to be up to speed and caught up on all your part B payments. Now let's look at the different types of plans there are. So there are basically four different types of Medicare Advantage plans.

The first one is an HMO, and that stands for health maintenance organization. The next one is a PPO and this stands for Preferred Provider Organization. And then we have PFS and that stands for private fee for service. And then finally we have an S and P and that stands for special needs plan. So let's look at each of these a little more closely. So you can get a description now what each of these are about. So for an HMO, this is for beneficiary beneficiaries, with HMO plans to receive coverage for care. So if you have an HMO plan, and you want to receive coverage for your care, you must receive services from doctors in your plans network.

Now, some plans do allow you to get care from out of out of an out of not sorry, some plans do allow you to get care from an out of network doctor. But the cost will oftentimes be higher. So for most people, you'll need a referral, you'll need it's a referral requirement from a specialist that will need to be in place. Now should your doctor or health care doctor leave, your plan will notify you and then following notification, you'll be able to choose another doctor within the program.

And then for our next one, we have PPO and with PPO plans, you'll pay less when visiting doctors. So that's the good news. Also, you'll pay less when visiting hospitals are basically any health care provider when they belong to the plans network. So that's the key they do need to belong to the plans network. And then each PPO gives freedom to go to hospitals and see specialists or doctors that aren't on your plans list.

So you have some differences now between PPO and HMO. So next, let's look at p FFS. So PFF s beneficiaries can seek health care from any medical doctor or hospital that agrees to the plans payment terms, and grants treatment of services. So the thing to keep in mind here is not all doctors will accept these payment terms. Of course, the cost will be higher, but you have options for out of network health care doctors and hospitals if they agree with the plans terms.

So some plans may cover the cost of prescription drugs. And if not, that's where you may enroll in Medicare Part D plan to help with that. Now these plans don't require choosing a primary care doctor. Certain plans have arrangements with a specific network of doctors and So again, this is for the PFFS. Now look at the last one, the s and p or special needs plans. These restrict enrollments to individuals with specific diseases or disabilities. And these plans adjust doctor choices. So SNPs have specialists in the diseases or conditions that their members endure. But otherwise, thanks so much for your time. Really appreciate you guys watching.

Hopefully this was helpful, and I'll look forward to seeing you in the next video.

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