Medicare Advantage plans are alternatives to traditional fee-for-service Medicare. The plans are sponsored by the federal Medicare program, which pays private health insurance companies to administer and provide coverage to those eligible for Medicare. In other words, Medicare coverage is provided by an insurance company like Humana or United Healthcare rather than directly from the Centers for Medicare and Medicaid Services.
There are several types of Medicare Advantage plans from which to choose:
1. Health Maintenance Organizations or HMOs.
These plans require beneficiaries to select a primary care doctor who manages all healthcare needs. Services from specialists require a referral from the primary care doctor before the plan will pay benefits.
2. Preferred Provider Organizations or PPOs.
These plans include a number of in-network providers who charge a lower co-payment than providers outside the network.
3. Private Fee-for-Service Plans or PFFSs
These plans allow beneficiaries to go to any Medicare-approved doctor or facility, as long as the specific plan is accepted by the provider.
4. Special Needs Plans or SNPs.
These plans are for people with people with certain health conditions or who are living in a nursing home.
To learn more about the Medicare Advantage plans that are available to California residents, please contact Bernardini & Donovan Insurance Services.