Advantage Plans - Medicare Part C
(formerly called Medicare + Choice or Medicare Part C)
Centers for Mediare & Medicaid Services (CMS) pays a monthly premium to the Medicare Advantage plan to provide your health care. The plan may require you to pay an additional premium and may charge you co-payments, deductibles, and co-insurance.
Medicare Advantage plans include
- Managed care plans, which include health maintenance organizations (HMOs), preferred provider organizations (PPOs), provider-sponsored organizations (PSOs), and other plans
- Private fee-for-service plans
- Special needs plans
To join a Medicare Advantage plan, you must have both Medicare parts A and B and live in an area that has a plan. Some plans have other eligibility criteria. Not all plans are available in each community.
Your choice of providers in a Medicare Advantage plan may be restricted. Medicare HMOs typically require you to use only physicians and hospitals in the HMO’s network. A Medicare HMO with a point-of-service option allows you to choose your own doctors, but you will have to pay extra. With a private fee-for-service plan, you can generally go to any doctor or provider and receive care anywhere in the in the United States. The doctor and provider, however, must agree to treat you and to accept the plan’s payment terms.
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