Understand the different types of Medicare Advantage plans and easily compare benefits, costs and coverage, so you can choose the best Medicare plan for you.


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Compare Medicare Advantage Plans

The benefits of Medicare Advantage plans can make them a great alternative to Original Medicare. However, it’s important to understand the differences of each plan before making a decision.

To help you choose what’s best for your needs, let's take a look at the types of Medicare Advantage plans and how they compare.

Medicare Advantage plans, known as Part C, are sometimes referred to as all-in-one packages for Original Medicare services. They cover Part A and Part B, and most include       Part D (prescription drugs)     as well. Some Medicare Advantage plans also offer benefits that aren’t available with Original Medicare, such as routine vision, hearing and dental care.

 To help you choose what’s best for your needs, let's take a look at the types of Medicare Advantage plans and how they compare.

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The most common Medicare Advantage plans are: 

    Health maintenance organization (HMO) plansHMO plans may sometimes offer lower premiums than other plans, but you must usually stay within your plan’s network for care and services.



    Preferred provider organization (PPO) plansPPO plans may allow you to go out-of-network for care, but you will usually pay less if you stay within the plan’s network.



    Private fee-for-service (PFFS) plansPFFS plans are offered through private insurance companies. You will pay health care providers directly for services based on an amount that your plan determines.



    Special needs plans (SNPs)*SNPs are tailored to meet the specific needs of members within the plan.





Referral requirements for specialist care

Contracted network of doctors and hospitals

Ability to use any doctors or hospitals outside of network<sup></sup>

To help you compare Medicare Advantage plans and see their differences, here are some important features to consider:

Coverage for prescription drugs (Part D)

Most Medicare Advantage plans offer prescription drug coverage, and all SNPs* must cover prescription drugs.1

Referral requirements for specialist care

Most HMO plans require you to get a referral from your primary care physician for specialist care, while PPO plans typically do not. Some PFFS plans and SNPs* require a referral.2

Contracted network of doctors and hospitals

All Medicare Advantage plans have a contracted network of doctors and hospitals that work in coordination to service your individual healthcare needs.

Ability to use doctors or hospitals outside of network

HMO plans generally require you to use doctors or hospitals in your network. PPO plans allow you to go outside of your network, but the cost may increase. PFFS plans let you go outside of your network if the doctor or hospital accepts the payment terms and agrees to treat you, and SNPs* generally require you to stay in your network.

Star ratings

Each year, the Centers for Medicare & Medicaid Services (CMS) releases the Medicare Advantage and Medicare Part D Star Ratings. These ratings go up to 5 and measure the quality of Part C and Part D plans based on up to 38 performance measures, including customer service, care coordination and availability of certain preventive care screenings.3

Everyone has different health needs. Be sure to look up your plan’s network, costs and its list of covered drugs before making your decision. By taking the time to research and compare Medicare Advantage plans, you can find the one that benefits you the most.

* SNPs can be any type of MA plan such as an HMO or PPO.

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    “Understanding Medicare Advantage Plans,” medicare.gov, last accessed August 9, 2023, https://www.medicare.gov/Pubs/pdf/12026-Understanding-Medicare-Advantage-Plans.pdf, PDF. 

    “Understanding Medicare Advantage Plans.”

    “Fact Sheet - 2022 Part C and D Star Ratings,” Centers for Medicare & Medicaid Services, last accessed August 9, 2023, https://www.cms.gov/files/document/2022-star-ratings-fact-sheet1082021.pdf, PDF.    

    “Biden-Harris Administration Announces Lower Premiums for Medicare Advantage and Prescription Drug Plans in 2023,” Centers for Medicare & Medicaid Services, last accessed August 9, 2023, https://www.cms.gov/newsroom/press-releases/biden-harris-administration-announces-lower-premiums-medicare-advantage-and-prescription-drug-plans.    



Plan feature	HMO	PPO	PFFS	SNP*
Coverage for prescription drugs (Part D)	Usually	Usually	Usually	Yes
Referral requirements for specialist care	Yes	No	Maybe	Maybe
Contracted network of doctors and hospitals	Yes	Yes	Yes	Yes
Ability to use any doctors or hospitals outside of network	Maybe	Yes	Yes	No

Compare common Medicare Advantage plans side by side