Choices are good when it comes to medical insurance, especially as you age. We all have different needs, restrictions, and financial capabilities that fit different options, but the wide selection can make choosing the right plan seem like an overwhelming task. MedicareGov Directory is here to make it as simple as possible. Our on-site tool can help you compare rates for several different kinds of Medicare supplement plans, whether you’re interested in Medigap or Medicare Advantage, and we have specialists standing by to help you with just a phone call.

To help you make more informed decisions about your Medicare supplements, we offer what help and clarification we have here in our blog. Our previous post covered the basics of Medicare Advantage plans, also known as Medicare Part C, including how it works and how to determine your eligibility. As we mentioned in that article, the coverage options and benefits available with your Medicare Advantage plan will depend on the specific kind of plan you choose, so in today’s post, we’ll be discussing two of the most common kinds of Medicare Part C plans.

HMO (Health Maintenance Organizations)

The best defining feature of an HMO Medicare Advantage plan is its restrictions on out-of-network providers. The coverage offered with this option only covers healthcare providers within the plan network, which include doctors and hospitals that have not only agreed to lower rates for plan members, but also meet the insurance company’s quality standards.

You are likely to have prescription drug coverage, which is a common aspect of Medicare Advantage plans in comparison to Medigap plans, but with an HMO plan, restrictions on coverage are common. That means the number of doctor visits, tests, and treatments that are paid for by your plan may be limited. You will also typically be asked to choose a primary care doctor, and any visits to or services done by a specialist will require a referral. If you decide that an HMO Medicare Advantage plan is what works best for you, and you want to limit your out-of-pocket costs, make sure that you follow the rules and limit out-of-network healthcare where you can.

PPO (Preferred Provider Organizations)

A PPO plan is somewhat more self-explanatory. As “preferred provider” may indicate, you have more flexibility with this plan to choose your provider in comparison to an HMO plan. You pay less when you visit an in-plan doctor or hospital, but you will not be entirely on your own if you do choose out-of-network healthcare. Prescription drugs are covered, and you likely won’t need a designated primary care doctor or a referral to see a specialist.

The drawback of PPO Medicare Advantage plans when compared to HMO plans is that the premiums are typically higher, and you often have to pay a deductible. Depending on your health insurance needs and your financial situation, you may decide that the advantages outweigh those drawbacks. MedicareGov Directory can help you make that decision.

The acronyms representing these plans probably seem confusing in of themselves, and the differences between the two options can be minute, but you are sure to find the right plan when you work with the professionals. MedicareGov Directory is the largest provider of Medicare Advantage plans in St. Louis, and not only are we very familiar with the possibilities of healthcare plans, but we also take the time to get to know you so we can truly help you find the Medicare supplement plan you need. Get started today by comparing Medicare supplement rates with our easy-to-use online tool or contact us by phone to talk to a specialist! We look forward to helping you.