Medicare Advantage Plans (formerly known as Medicare+Choice — HMO, PPO, PFFS, SNP, MSA)
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A Medicare Advantage (MA) plan is an alternative to Original fee-for-service Medicare and a Medicare supplement insurance policy (also known as Medigap policies). Medicare sponsors MA plans as part of the Medicare program and pays the plans a monthly fee to manage beneficiaries' health care. In order to join one of these plans, you have to have Medicare Part A and Part B and you must continue to pay the Part B premiums ($96.40 in 2008). MA plans are required to accept you if you apply when you are eligible to do so (except if you have end stage renal disease [ESRD]).
If you enroll in a Medicare Advantage plan, you no longer have Original Medicare; instead your Medicare benefits are covered by the Medicare Advantage plan. These benefits must include all Medicare Part A and B services, and may also include some additional services that are not covered by Original Medicare. Note, however, that you generally have to see doctors that belong to the plan or go to certain hospitals to get services.
There are different types of Medicare Advantage plans: the Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), Private Fee-for-Service (PFFS), Special Needs Plan (SNP) and the Medicare Savings Account (MSA). Some Medicare Advantage plans include prescription drug benefits and are known as MA-PDs (Medicare Advantage Prescription Drug plans). Other Medicare Advantage plans do not include outpatient prescription drug benefits (other than certain drugs that are covered under Part B), and are known as MA-only plans. Note that the type of MA plan you join determines whether or not you can join a stand alone prescription drug plan (PDP) if your MA plan does not offer Part D drug benefits.
For more information on Medicare Advantage Plans including details on the various types of plans listed above, please see our section Medicare Advantage: an overview.
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Page updated September 10, 2008
