HMO (Health Maintenance Organization)

• Usually requires members to use doctors and hospitals within the plan's network, except for emergencies or other situations allowed by the plan.

• Members generally select a primary care provider who coordinates their care.

HMO-POS (Health Maintenance Organization – Point of Service)

• Combines features of an HMO with the ability to receive certain services outside the plan's network.

• Out-of-network services may have higher costs.

PPO (Preferred Provider Organization)

• Allows members to receive care from both in-network and out-of-network providers.

• Members generally pay less when using providers within the plan's network.

PFFS (Private Fee-for-Service)

• Determines how much the plan will pay doctors and other healthcare providers and how much the member will pay.

• Members may be able to see providers that accept the plan's payment terms.

SNP (Special Needs Plan)

• Designed for people with specific health or financial circumstances.

• Includes plans for people who live in institutions, have certain chronic conditions, or qualify for both Medicare and Medicaid.

MSA (Medicare Medical Savings Account)

• Combines a high-deductible Medicare Advantage plan with a medical savings account.

• The plan deposits money into the account to help pay for qualified medical expenses.

Medicare Cost Plan

• A type of Medicare health plan that may allow members to receive services outside the plan's network.

• Members may return to Original Medicare for certain services.

Medicare Prescription Drug Plan (PDP)

• A standalone Medicare Part D plan that provides prescription drug coverage.

• These plans are generally used with Original Medicare and may also coordinate with certain other Medicare coverage.

Medicare Supplement (Medigap)

• Private insurance policies that help pay some healthcare costs that Original Medicare does not cover.

• Depending on the policy, this may include certain deductibles, coinsurance, and copayments.

• Medigap policies generally require enrollment in Medicare Part A and Part B.

Dental, Vision, and Hearing Products

• Products that provide additional benefits for dental, vision, or hearing services.

• Coverage and benefits vary depending on the specific product and plan.

• These products may be offered separately from Medicare health coverage.

Hospital Indemnity Products

• Plans offering additional benefits; payable to consumers based upon their medical utilization; sometimes used to defray copays/coinsurance.

• These plans are not affiliated or connected to Medicare.