Compare Medicare Advantage Plans
It’s good to know your options when comparing Medicare Advantage plans. These plans package all the benefits of Medicare Part A and B into one plan that covers your hospital and medical costs. Many Medicare Advantage plans also include Medicare Part D (prescription drug coverage). Knowing how the plan will help you pay for hospital and medical benefits is a good place to start. But there are many other things to consider. It’s important to think about whether you prefer an HMO or PPO, costs, prescription drug benefits, doctors, and quality.
One of the differences between Medicare Advantage plans is that there are HMOs and PPOs. Deciding whether you want the choice and flexibility of a PPO or the management and predictability of an HMO is the first step. Based on that first choice, you can narrow your choices in other ways. You will have different options for the type of doctors you will be able to see and what you will pay based on your choice of an HMO or PPO.
Next, it’s good to know that most Medicare Advantage plans include Medicare Part D (prescription drug coverage). If you take any medications, compare the prescription drug coverage for each plan that you are interested in. Knowing which drugs are covered, how much you will pay for your medications, and where you will get your prescriptions are all important questions.
Finally, consider other measures such as quality. Medicare Advantage Plans are rated by Medicare. Star Ratings measure Medicare Advantage plans on a number of categories including customer service and quality of care. *
The chart below will help you understand some of the differences between HMO, PPO and other types of plans to help you compare Medicare Advantage plans.
*(Medicare evaluates plans based on a 5-star rating system. Star Ratings are calculated each year and may change from one year to the next.)
Medicare Advantage (Part C) Comparison:
- You get most of your care from a network of providers, unless it is an emergency.
- You may also need a referral from a primary care physician to see a specialist.
- HMO costs tend to be lower than PPOs as long as you receive care within the network.
- Selecting providers outside of network or not getting a referral will cost more.
- You like lower costs and don’t mind receiving care from one network of providers.
- Your providers are participating in the network.
- You like having a primary care physician coordinate all of your care and provide referrals for other specialists and other tests.
- PPOs have a network of doctors and health care providers, but you can also see providers that aren’t on the list.
- You don’t need a referral to see a specialist.
- PPOs tend to have higher costs than HMOs.
- You will pay more if you see a doctor outside the network.
- You are looking for more flexibility in the doctors you see.
- You don’t mind paying a little bit more for your plan or for seeing a doctor that is not in the network
- Rather see a specialist or get tests without a referral.
- SNPs are a type of plan that specialize in the diseases or other characteristics of those enrolled.
- Doctors available to members tend to be specialists familiar with the condition the plan is focused on.
- SNPs plan are often low-cost to help people with serious illnesses or who meet other conditions.
- Normally you will see doctors within the network. If you choose to see someone outside the network you will pay more.
- You have a chronic health condition such as chronic heart failure, diabetes, ESRD, COPD, or CHF, and/or;
- You qualify for Medicaid, and/or;
- You live in a qualified long-term care facility.
Want more help comparing Medicare Advantage Plans?
We can help you find a Medicare Advantage Plan based on what’s important to you. Answer a few quick questions about your preferences related to HMOs, PPOs, and your plan needs and we’ll provide a recommendation on the Medicare plans that match you best. Then you can compare those plans based on benefits, costs, quality, prescription drug coverage, and doctors.Shop Plans