Health & Wellness / Medicare Toolbox / Your Medicare Advisor

Medicare HMO Plans vs. Medicare PPO Plans: What’s the Difference?

medicare form enroll plansThere are many different types of Medicare Advantage Plans (Part C). When a client is enrolled in a Medicare Advantage Plan, benefits are provided through a Medicare-approved private insurance company. Two of the most common plans are Medicare HMO’s and Medicare PPO’s.

A Medicare Advantage HMO plan offers some of the following features:

  • Contracted network of doctors and hospitals
  • Must choose a primary care physician
  • Must use network providers for covered services
  • Most plans require a referral to see an in-network specialist
  • May include drug coverage depending on the plan selected
  • Covers emergency care received from any provider

A Medicare Advantage PPO Plan offers some of the following features:

  • Contracted network of doctors and hospitals
  • Many plans do not require you to select a primary care physician
  • Coverage for in-network and out-of-network providers (may pay more for out-of-network)
  • Most plans do not require a referral to see a specialist
  • May include drug coverage depending on the plan selected
  • Covers emergency care received from any provider

As you can see, there are key differences between Medicare HMO plans and Medicare PPO plans. Remember—everyone’s needs are different, and you are the best judge of which coverage would work best for you.

 

If you have any questions please call AMAC’s Medicare Department to speak to one of our Trusted, Licensed Insurance Agents

Call 1-800-334-9330 or Get Quote

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