The Annual Election Period, which occurs from October 15th to December 7th, is a great opportunity to make changes to your Medicare coverage. And, if you want to change Advantage plans, now is the time to do so.
Let’s take a look at the different Advantage plans and how to transition from one to another.
Medicare Advantage Special Needs Plans (SNPs)
One of the less common types of Medicare Advantage is the Special Needs Plan (SNP). Generally, you must have a specific illness, condition, or economic status to qualify for this plan, unlike the others that do not have specific eligibility requirements.
If you do qualify for an SNP, you should absolutely sign up for one. They provide great benefits catered to your specific needs — generally, these benefits and more may be fully covered:
- Monthly premiums
- Care coordination
- Vision and hearing benefits
- Over the counter quarterly benefits
- Transportation benefits
- Telehealth services
- Gym memberships
- Part D coverage
Private Fee-for-Service (PFFS)
All Medicare Advantage plans work to coordinate your healthcare in order to lower your total out-of-pocket costs. Each one, however, does this in different ways, and your choice of plan depends simply on your preferences and medical habits and requirements.
Private Fee-for-Service (PFFS) plans, like all Advantage plans, function within a network. All care received within this network will have lower costs than one out-of-network.
PFFS plans, however, offer a lot of flexibility and autonomy in the negotiation of this network — in other words, you have the option to work with healthcare providers yourself to come to an agreed cost. This plan is especially beneficial to travelers.
Health Maintenance Organization (HMO)
Health Maintenance Organization (HMO) plans, on the other hand, rely very heavily on this network without much “wiggle room,” so-to-speak. For instance, unlike the other options, you must receive care from a primary care doctor before seeing a specialist.
However, these limits allow for a significantly lower cost than the other options.
Preferred Provider Organization (PPO)
Compared to the other options, Preferred Provider Organization (PPO) Plans:
- Allow for doctors in more cities and states than other Medicare plans
- Do not referrals needed for specialist care
- Do not require primary care doctors
- Cover prescription drugs (in most cases)
In general, then, PPO plans offer somewhat of a middle ground between PFFS plans and HMO plans — you cannot negotiate the network yourself like with a PFFS plan, but it still offers a wider coverage range than an HMO plan.
Call Trusted Senior Specialists
Now that you know your options, how do you know which is best for you? Where and when do you sign up? Is the Annual Enrollment Period best for you? That’s where we come in — for free insurance guidance, call the Trusted Senior Specialists at (855) 952-1941.
