Medicare Part C, or Medicare Advantage Plans are health care options, such as an (such as an HMO or PPO)

approved by Medicare and offered by private insurance companies.

 

When you enroll in a Medicare Advantage Plan, Medicare pays a fixed amount every month to the

insurance company that provides your health insurance. Companys that offer Medicare Advantage

Insurance must follow rules that are set by Medicare.

 

Medicare Advantage Plans are NOT supplemental insurance (or Medigap). Instead, they take the

place of Original Medicare and a Supplemental Plan (although you do NOT lose Medicare when you

enroll in a Medicare Advantage Plan).

 

If you are considering a Medicare Advantage Plan, you should seriously consider talking to a qualified

broker who can compare your options and help you make an informed decision.

 

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Frequently Asked Questions about Medicare Advantage Insurance

 

Q. What is an HMO?

 

A. HMO stands for "Health Mainatainance Organization."

 

In practical terms, it is a planned network of "hospitals, physicians, specialists and other healthcare services."

Normally, if you are enrolled in an HMO, you have what is called a "primary care physicial" (or PCP).

 

When you need to see a specialist, normally, your regular doctor will give you a referral to a specialist

within the network.

 

Some feel that HMO's are a good option because they are able to keep costs lower.

 

Others feel that the true "out of pocket" expenses may be equal to or greater than traditional Medicare

with a Medicare Supplment. We have found that it really depends on your individual situation and that "one

size never fits all." If you are considering enrolling in an HMO, you should consult with a qualified

insurance broker who can help you compare your options.

 

Watch the video below to learn more about HMO's

 

 

 

 

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Q. What is a PPO?

 

A. PPO stands for "Preferred Provider Organization."

 

In practical terms, it is a network of "preferred" health care provdiders.

 

In a PPO, your plan "prefers" that you see a network physician or specialist, but they don't "require"

that you do. Normally, if you go "outside" of the preferred network, you will pay additional costs.

 

A PPO may be a good option if you want to keep your costs down, but you want the additional freedom

to go outside of the network if you choose to do so.

 

If you are considering enrolling in an PPO, you should consult with a qualified insurance broker who can

help you compare your options.

 

Watch the video below to learn more about PPO's

 

 

 

 

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Q. What is a PFFS Plan?

 

A. PFFS stands for "Private Fee For Service"

 

A Private Fee for Service Plan does not normally use any kind of network. This allows you

additional freedom to choose physicians and hospitals.

 

You must understand however that any doctor or hospital you choose must agree to the

terms of the plan (they are not required to accept the terms and conditions of the plan). This process

is known as "Deeming."

 

This is why it is very important that you make sure your doctor or hospital accepts the plan before

you enroll. It is also important to keep in mind that doctors or hospitals that accept the plan may

change their minds at any time. Before enrolling in a PFFS plan, you should always check with a qualified

broker to make sure that the plan is a good fit for your situation.

 

Watch the video below to learn more about PFFS plans...

 

 

 

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