Compare types of Medicare Advantage Plans
| Plan Type | Health Maintenance Organization | Preferred Provider Organization | Private Fee-for-Service (PFFS) Plan | Special Needs Plan | Medicare Savings Account |
|---|---|---|---|---|---|
| Premium Do most plans charge a monthly premium? | Yes Many charge a premium in addition to the monthly Part B premium. | Yes Many charge a premium in addition to the monthly Part B premium. | Yes Many charge a premium in addition to the monthly Part B premium. | Yes Many charge a premium in addition to the monthly Part B premium. | No You won't have to pay a separate monthly premium, but you'll continue to pay your Part B premium. |
| Drugs Does the plan offer Medicare prescription drug coverage (Part D)? | Usually If you join an HMO plan that doesn’t offer drug coverage, you can't get a separate Medicare drug plan. | Usually If you join a PPO plan that doesn’t offer drug coverage, you can't get a separate Medicare drug plan. | Usually If your PFFS Plan that doesn’t offer drug coverage, you can get a separate Medicare drug plan. | Yes All SNPs must provide Medicare drug coverage (Part D). | No You may join a separate Medicare drug plan. |
| Providers Can I use any doctor or hospital that accepts Medicare for covered services? | Sometimes You generally must get your care and services from doctors, other providers, or hospitals in the plan’s network (except emergency or urgent care or out-of-area dialysis). In an HMO Point-of-Service (HMOPOS) Plan you may be able to get some services out of network for a higher copayment or coinsurance. | Yes Each plan has a network of doctors, hospitals, and other providers that you may go to. You may also go out of the plan’s network, but your costs may be higher. | Yes You can go to any Medicare-approved doctor, other health care provider, or hospital that accepts the plan’s payment terms and agrees to treat you. If the plan has a network, you can use any of the network providers. (If you go to an out-of-network provider that accepts the plan’s terms, you may pay more.) | Sometimes If your SNP is an HMO, you must get your care and services from doctors or hospitals in the SNP's network (except for emergency, urgent care, or out-of-area dialysis). However, if your SNP is a PPO, you can get Medicare-covered services out of network. | Yes MSA plans generally don’t have network providers. You may go to any Medicare-approved provider for services that Original Medicare covers. |
| Primary Care Do I need to choose a primary care doctor? | Usually | No | No | Varies by plan Some SNPs require you to choose a primary care doctor and others don’t. | No |
| Referrals Do I need a referral from my doctor to use a specialist? | Yes | No | No | Maybe If the SNPs is an HMO, you need a referral. If the SNP is a PPO, you don't need a referral. | No |