Your health plan options
Medicare health plans are another way to get your Part A (Hospital Insurance) and Part B (Medical Insurance) benefits instead of Original Medicare. There are several types of plans to choose from, including Medicare Advantage Plans (Part C). Learn about rules Medicare plans must follow when they contact you.
Medicare Advantage Plans
If you have Part A and Part B, you can join a Medicare Advantage Plan, sometimes called “Part C” or an “MA plan.” This type of Medicare health plan is offered by Medicare-approved private companies that must follow rules set by Medicare. Most Medicare Advantage Plans include drug coverage (Part D). Types of Medicare Advantage Plans: Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), Special Needs Plans (SNP), Medicare Medical Savings Account (MSA) Plans, Private Fee-for-Service (PFFS) Plans.
Before joining a Medicare Advantage plan
Talk to your employer, union, or other benefits administrator about their rules before you join a Medicare Advantage Plan. In some cases, joining a Medicare Advantage Plan might cause you to lose your employer or union coverage. If you drop or lose employer or union coverage for yourself, you may also lose coverage for your spouse and dependents. You may not be able to get this coverage back. Insurance companies can decide if a plan will be available to everyone with Medicare in a state, or only in certain counties.
Insurance companies may also offer more than one plan in an area, with different benefits and costs. Each year, insurance companies can decide to join or leave Medicare.
If a plan decides to stop participating in Medicare, you’ll have to join another Medicare health plan or return to Original Medicare.
The grace period is at least one month long, but plans can choose to have a longer grace period. If you lose eligibility for the plan, you'll have a Special Enrollment Period to make another choice.
This Special Enrollment Period starts when your Medicare Advantage Plan notifies you that you're no longer eligible for the plan. It continues during the plan's grace period, and if you're disenrolled from the plan at the end of the grace period, it continues for 2 months after your coverage ends. It's very important to review your coverage options at this time to make sure you continue to have the Medicare health and prescription drug coverage you want.
What's an HMO?
An HMO is a type of
Medicare Advantage Plan (Part C)
offered by a private insurance company. When you have an HMO, you generally must get your care and services from doctors, other health care providers, and hospitals in the plan's network, except:
Out-of-area urgent care
Temporary out-of-area dialysis
Some HMOs are Point-of-Service (HMOPOS) plans that may allow you to get some services out-of-network for a higher copayment or
coinsurance. It’s important that you follow the plan’s rules, like getting prior approval for a certain service when the plan requires it.
What's a PPO?
A PPO is a type of
Medicare Advantage Plan (Part C)
offered by a private insurance company. PPOs have networks of doctors, other health care providers, and hospitals.
You pay less if you go to providers and facilities that are belong to the plan's
You can generally go to out‑of‑network providers for covered services, but you’ll usually pay more.
By adding your initials and submitting the form, you provide your electronic consent to receive all forms of communications regarding your health insurance options. Your consent to receive communications in this way is not required as a condition of purchasing any goods or services.
ethanadvisor.com is an online resourse company, and we are not affiliated with the United States government, the federal Medicare program and not appointed by any insurance carrier. This communication is intended for informational purposes only and is not an offer of insurance. V. Ethan Vaisman or their associates, subsidiaries, affiliates, or carriers are authorized to offer Medical Indemnity Plans, Critical Illness Plans, Medicare Supplement (Medigap) Insurance, Medicare Advantage (Part C), and/or Medicare Part D. from various insurance carriers. The availability of these plans may vary by location.
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The contents of this website are subject to change without notice. If you would like to find more information about the Government Medicare program please visit the Official US Government Site for People with Medicare located at www.medicare.gov.
Should you schedule a call, you will speak with a licensed sales agent who can answer your questions and provide information about Medicare Supplement Insurance plans, Medicare Advantage and/or Medicare Part D plans. Neither ethanadvisor.com nor V. Ethan Vaisman or their associates, subsidiaries, affiliates, or carriers are connected with or endorsed by the U.S. government or the federal Medicare program.