Medicare Advantage Plans

Medicare Advantage Plans are sold by private insurers approved by Medicare and provide your Part A and B coverage. They cover "medically necessary" benefits, and sometimes include Part D drug coverage.

The most common MA Plan types are:

Health Maintenance Organization (HMO). HMOs require you to see doctors on their approved list, but also tend to offer greater benefits and lower costs. 

  • Preferred Provider Organization (PPO). PPOs let you see any doctor, but you pay less if you see plan-approved doctors.
  • Private Fee for Service (PFFS). PFFS Plans let you see any doctor who accepts the plan’s payment.  
  • NOTE: Not all doctors accept all PFFS Plans.

Medicare Advantage Prescription Drug Coverage

Some MA Plans also offer drug coverage.  These are called Medicare Advantage Prescription Drug Plans (MAPD Plans). You are required to use drugs on an approved list, the plan may pay part of your Part B or D premium, they plan may also cover drugs through the coverage gap, and often offer cheaper copayments for generic or mail-order drugs.

NOTE: If you are in a MA Plan with drug coverage and you join a stand-alone drug plan, then you may be disenrolled from your MA Plan and return to Original Medicare.

Special Needs Plans

Special Needs Plans (SNPs), another type of Medicare Advantage Plan, offers services and benefits especially tailored for those who need specialized care and/or focused care management. Read More About SNPs